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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 />PHONE CONTACT FOR PERMITTING Jr2-'/2, '1-d7r7 <br /> <br /> <br />PHONE <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />DSIGN <br /> <br />o ADDITION <br /> <br />P(ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />j'4COMMERCIAL <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />/?L-MO j) L iF <br /> <br />DMULTI - 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 />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <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 />[J BUILDING <br /> <br />$ <br /> <br />;21'100 <br />, <br /> <br />~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />3'(df'11:RVI~E ~ Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o ELECTRICAL <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />6 <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:~ BLOCK <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />I S PROJECT IN FLOOD ZONE AREA 0 YES .Af NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br /> <br />COMPANY <br /> <br />;vi /l A //"u <br /> <br />i: Le-i! r~/ c=---., <br />/3CAD /3g- 3 <br /> <br />ELECTRICIAN <br /> <br />STATE CERT OR REGIST # <br /> <br />PLUMBER <br /> <br />****************************************************************** <br /> <br /> <br />4!i: .I ~ COMPANY ?t74 c4YtJt"~ !'1t/mtJt~f' ..L4c. <br />tV; ~ STATE CERT OR REGIST # GFr::j lj:l." 1 j? <br />/' .~ <br />*** ************************************************************** <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST * <br /> <br />OTHER <br /> <br /> <br />********************************************************* <br /> <br />COMPANY rd/,??p/e 7e <br />, <br /> <br />!JryGt./&; # (} 'T ;l!e""'4--?dc <br />., ~--?C. <br /> <br />SIGNATURE <br /> <br />STATm R REGIST # <br />ttlt1? ~ kle1112 . *,4 ~ <br />tt<f\''; ~r.\"_'.J)"~'~ nl)t.PaiifWnt\J ~ .... . <br />:':'~')'.."~;".~~li..tlftrJj .~ .', IItt <br />.." ~'\ .~' ~;~:.,"t1 t,,'1.j;tfJo~'i va....... .#..~,:...~ <br />