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04-3657
Zephyrhills
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04-3657
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Last modified
3/6/2009 3:21:37 PM
Creation date
2/8/2007 11:58:24 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
04-3657
Building Department - Name
MIKULCIK,GEORGE
Address
39680 MEADOWOOD LP
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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 />PHONE CONTACT FOR PERMITTING <br /> <br />"" <br />OWNER'S NAME &:-Ebgr;E /YI1 K L-{ LC II( <br />JOB ADDRESS 3 c:; fa 80 IV\ E A- 1::>oUJ <::70 b <br /> <br />PHONE 7 g 8; L/fO ~L <br /> <br />LOO F <br /> <br />SUBDIVISION ~ e A-j)c:uJ(SCJL) ~o p <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br /> <br />[J COMMERCIAL <br /> <br />[JMULTI - FAMIL Y <br />[J INDUSTRIAL <br /> <br />0# OF UNITS <br />[J SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />R-ESI-I) ~ G-U~ <br /> <br />{200j:: <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 />[J BUILDING $ is'So VALUATION OF TOTAL CONSTRUCTION <br />[J ELECTRICAL AMP SERVICE [J Progress Energy [J W.R.E.C. <br />[J PLUMBING <br />D MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION <br />D GAS o ROOFING o SPECIALTY 0 OTHER <br /> <br />TYPE OF CONSTRUCTION: D BLOCK <br /> <br />D FRAME <br /> <br />D STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPAN~~ <br /> <br />~"--:n '{ ...". li1.- <br />SIGNATURE ---.-----:::f/ ~ <br />( <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 />MECHANICAL <br /> <br />****************************************************************** <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 />
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