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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />II, lJ-ol./ ~ <br /> <br />PHONE CONTACT FOR <br /> <br />PERMITTING . . e .. <br />'!\,SCO r\EHMII SER\ii l:. <br />1-866-824-7894 <br />Toll F r-ee <br /> <br />PHONE <br /> <br />OWNER'S NAME T'fJl>( -I (jfL/'ba..rCc. II roin <br /> <br />JOB ADDRESS J.Jalj At IL 4 /lJLr;ne W/LL/ <br /> <br />LEGAL DESCRIPTION' LOT (S) II BLOCK v SU.llDIVI S ION c:f1e~Jd /"t7/nk <br />12 /I ~vorr LJ. ~ / <br />o.lY-ol~ - ~/- O()~o- OOO<.XJ -0110 (OBTAIN FROM ~ROPERTY TAX NOTICE) <br /> <br />PARCEL 10 # <br /> <br />WORK PROPSED: DNEW CONSTRUCTION p(iADDITION DALTERATION o REPAIR o INSTALL <br /> DSIGN o MOVE 0 DEMOLISH <br />PROPOSED USE: ~SGL FAMILY DWELLING DMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />room cui tI (///IIh \SA e.eI <br /> <br />, <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />r- eON.re.~ p#/'t-I) <br />. <br /> <br />'I (,f" P <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. <br /> <br />PERMITS REQUESTED <br /> <br />6i BUILDING <br /> <br />$ rJ...3, () 00. 00 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />0' ELECTRICAL <br />~PLUMBING <br />~ECHANICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o 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 AREAD YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY S U.IJ u/.tLit <br /> <br />AIuAI/JI//YJ.XAe <br />. <br /> <br />SIGNATURE <br /> <br />~~~l(' <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICI~ <br />SIGNATURE L~ <br /> <br />a~c::f ~ <br /> <br />COMPANyi!.,leALrd trwrJ/ <br /> <br />c~e~tl! <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br /> <br />COMPANY C LriJ IJ 4-lr <br /> <br />/J kuw.J liJ9 <br />R.Foo 9/.s<I8' <br /> <br />, <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />~;)JL <br /> <br />******************************************************** <br /> <br />(JUr'~ fJropa./J-t. ~.,. Ale.. <br />r . <br /> <br />COMPANY <br /> <br />MECHANICAL <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />