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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 />/ /. 5'- .:76t:N <br /> <br />OWNER'S NAME ThL Y0Uf\8 G~f. Tnc:-. <br />JOB ADDRESS 5'1'1../ Gd-ll \3(vJ. <br /> <br />PHONE CONTACT FOR PERMI~.TtNG K~3- ~76.;;n4 <br />\...... '- c".'~ ~._:_..~ <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # 1\-.,2!1-..2\...06l0"00200'" 0010 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: )aNEW CONSTRUCTION <br />OSIGN <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />~COMMERCIAL <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <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 />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK ~l\ K;~^ ~dtd H;e...~ ~5'kA' <br />BUILDING SIZE SQUARE FOOTAGE HEIGHT <br /> <br />o BUILDING <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. 11 -;fj, W/I <br /> <br />U Y 61lfJ /:~" <br /> <br />PERMITS REQUESTED \'-1)JIfV//o~ \]1 //;/ "1/1) <br />II" / r 11 & ') ~ I <br /> <br />VALUATION OF TOTAL CONSTRUCTION ( ;ft c?~~ <br /> <br />AMP SERVICE 0 Progress Energy 0 W.~ <br /> <br />$ <br /> <br />o ELECTRICAL <br /> <br />o PLUMBING <br />F MECHANICAL <br /> <br />$ <br /> <br />/~:l5~ <br /> <br />,1 <br />VALUATION OF MECHANCIAL INSTALLATION ~: <br />o OTHER /1 <br />o STEEL 0 OTHER / <br />IS PROJECT IN FLOOD ZONE A~AD' <br /> <br />YES <br /> <br />o NO <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />SIGNATURE <br /> <br />I <br />;' <br />! <br />STATE CERT OR REGIS! # <br />I <br />***************************************************~************* <br />/ <br />/ <br />/ <br /> <br />STATE CERT OR lEGIST # <br /> <br />**********************************************~****************** <br />/ <br />/ <br /> <br />COMPANY <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br /> <br />REGIST # <br /> <br />***************************************** <br /> <br />MECHANICAL <br /> <br />COMPAN <br /> <br />SIGNATURE <br /> <br />STATE CERT <br /> <br />d2qL~ 0, <br />******0**** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />