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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 RECE IVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />. <br /> <br /> <br />OWNER'S NAME Sf {)( e. ~(J {J I e... <br />] / . <br />JOB ADDRESS to '- L. '2- \ 0. (2., Ie s: 1- <br /> <br />PHONE J3J3' ...7ffJ, -75 71l-' <br />-3/5 -l!o8' -- ;;2- / h~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION O!JJ:S/06' Pic . <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />Os I GN <br /> <br />)Q ADDITIONS' <br />o MOVE <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE:~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI - FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />~THER <br /> <br />, I <br />D RESTAURA~ & HEALTH DEPARTME~~ APPROVAL ~;< J;3 <br />18 i--B UrfC'rfL)I$t9t.3/ /i ;tJ,4n/ 12"~fj(A/~hI,P()k':, sefj,.lce':i-f'f,V ~:- r e- t?ddd-tt77L <br />DESCRIPTION OF WORK <br />(Cl~<YL+) ~."C!..\..s!C l't-ifl I. , ~ <br />, . (~, ~ (..0(/. I .. <br />BUILDING SIZE ~ '11"3' \,,,))'-13) SQUARE FOOTAGE A, <br /> <br /> <br />;,e1 BUILDING <br />o ELECTRICAL <br /> <br />PERMITS REQUESTED <br />,v to' /...~e- <br />$ APPRNI.. '" 15CC.6'D <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. p\!Y' <br />/ 0 ~6 <br />~/~ <br /> <br />~ <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <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 Q( NO <br /> <br /> <br />SIGNATURE <br /> <br /> <br />COMPANY <br /> <br />v~ <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />*************** ******************:::::::**********O~******** <br /> <br /> <br /> <br /> <br />~--?lL-< ~ tl Y- ' STATE cERT OR REGIST I <br />****************************************************************** <br /> <br />ELECTRICIAN <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 />