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<br />OWNER'S NAME <br />'A5;;"Q <br />JOB AI:IDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) ,-~0 BLOCK~O <br /> <br />PARCEL 10 # 03~~~0...;zj -O,;J.~D-9{)~oo-rDO(h([) <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 I 0 ~/ <br />DATE RECEIVED ---1 _ - 21- C Y <br /> <br />PHONE CONTACT FOR PERMITTING 7 R..2-tO SJ .:( 5 <br />&~ <br /> <br />PHONE sYI5-??~--OR~r <br /> <br />e. <;. ~ <br /> <br /> <br />SUBDIVISIO~~-;u-e/ral)...c L l {(t;r; <br />{ <br />(OBTAIN FROM PROPERTY TAX NOTICE\ <br /> <br /> <br /> <br />WORK PROPSED: ~ CONSTRUCTION o ADDITION DALTERATION o REPAIR o INSTALL <br /> Os I GN o MOVE 0 DEMOLISH <br />PROPOSED USE: ~AMILY DWELLING DMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />l' ~ / ,. <br />DESCRIPTION OF WORK II e-L-L>...c t rl'9./~ 'T.a> ~'Y\. l k( res l. cc.lL.-<'~ <br /> <br />BUILDING SIZE .26 'P~X &';;2../ SQUARE FOOTAGE ,.'::)J 7~ HEIGHT 9 I <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~LDING <br /> <br />$ / t.j~ S"t:n 00 <br />~()O <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />.J:}-'ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />~UMBING <br />~CHANICAL <br />o GAS ~FING <br /> <br />'?v-~cE) <br />$'--:'>; L LfC-_ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />1 <br />At;1 <br />~'j' <br /> <br /> <br />~ <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: ~CK <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br /> <br />LeJ~ <br /> <br />COMPANY <br />~ STATE CERT OR REGIST # (! ~~ - 0.35/ Z5 ~ <br /> <br />***************************************************** <br /> <br />********** <br /> <br />~MP NY'{Y\.2'-~ ~~. <br />ST CERT ~ REGIS""'T # Fc- ) 6 CD j.?:. g'2 <br /> <br /> <br />* * * * * * * * * * * * * * * * * * * * * * * "* * ~ * ~~ cI~ * * * * * * * * <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br /> <br />PLUMBER <br /> <br /> <br />A'7~~~ <br /> <br />COMPANY ~ ~o.--<~ <br />STATE CERT OR REGIST #C-k. / Ljd.. 5.... ~{'),;;L <br />, <br /> <br />SIGNATURE <br />----= <br /> <br />,.' <br /> <br />********************************* ****t*****~******** ~ <br />~OMP NY . G2- r\'~ \rD G-....yL>........ ~ ~ <br /> <br />-<",-y~ ST CERT O~EGTST # ~ tDLf3;.J7~ <br />, ~'fl~- <br />*************************~*********~****** <br />COMPAN~~~~'~ <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />OTHER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST #~ } 2C:::Z E: 5' 0 S <br />