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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH st, Zephyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />11- /5 -0 Y <br /> <br />PHONE CONTACT FOR <br /> <br />P~PERMIT SERVICE <br />1-866-824-7894 <br />Toll Free <br /> <br />PHONE <br /> <br />UJIOJ 0 I) <br />/O;re. M <br /> <br />LEGAL DESCRIPTION: LOT (S) / i <br />oJ -C)& -tJ.-/- 0010 -a-ooo -0630 <br /> <br />OWNER'S NAME <br /> <br />T;m <br /> <br />JOB ADDRESS <br /> <br />[QfL/~ <br /> <br />SUBDIVISION S WI!!! iItJ//au :z <br />(OBTAIN FROM PROPERTY TAX NOTICE\ <br /> <br />BLOCK <br /> <br />PARCEL 10 # <br /> <br />WORK PROPSED: olNEW CONSTRUCTION <br />OSIGN <br />USE: rlSGL FAMILY <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED <br /> <br />DWELLING <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />cSeH.eA- room <br /> <br />BUILDING SIZE <br /> <br />/cJt-,3tJ <br /> <br />SQUARE FOOTAGE <br /> <br />o {XJ rp <br /> <br />HEIGHT <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. (Q0._'''' hL{)G, <br /> <br /> PERMITS REQUESTED <br />~ BUILDING rJ> <br />$ tJ JJOO . VALUATION OF TOTAL CONSTRUCTION <br />0 ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br />0 PLUMBING <br />o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION <br />o GAS o ROOFING o SPECIALTY 0 OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />