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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 />/ J-,j, '3 - DJ.! <br /> <br />DATE RECE IVED <br /> <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />;2133N . <br />. PHONEg3l78~-o8~ <br />(4LA<4 C-<- <br />LEGAL DESCRIPTION: LOT(S) ~fJt- BLOCK~ SUBDIVISION~~Q-A~ <br />PARCEL 10 # 54-~ -d:2j- Of30- ~ - 0 L./3. (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPSED: ~ CONSTRUCTION 0 ADDITION DALTERATION 0 REPAIR 0 INSTALL <br /> <br />OWNER'S <br /> <br />JOB ADDRESS <br /> <br />o SIGN <br />PROPOSED USE:~ILY DWELLING <br />o COMMERCIAL <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 /> <br />DESCRIPTION OF WORK d1~..s;;: {n~ Ie... ~'t /1. re. ~'((~~~ <br />a>/ <br />BUILDING SIZE ~ ,0 SQUARE FOOTAGE dtZ/7"1 HEIGHT 0 <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 />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />~~ <br />?~ \p -J; <br /> <br />~ILDING <br />~LECTRICAL <br /> <br />PERMITS REQUESTED <br />$ q~J!t:/fX)( €X; <br />~(D <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />AMP SERVICE ~rogress Energy 0 <br /> <br />W.R.E.C. <br /> <br />~UMBING <br />~HANICAL $ ~ ~ < ~ VALUATION OF MECHANCIAL INSTALLATION <br />o GAS ~ING 0 SPECIALTY 0 OTHER <br />TYPE OF CONSTRUCTION ~OCK 0 FRAME 0 STEEL 0 OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~ <br /> <br /> <br />BUILDER <br />SIGNA;UR&~~ <br /> <br />STATE CERT OR REGIST # C-i:e 03S 13 tf <br /> <br />****************************************************************** <br /> <br /> <br />COMPANyttQ~Y- ?~~D~~ <br />STATE ~ERT OR REGIST # ER f{)Dlc.I S7/ <br /> <br /> <br />SIGNATURE <br /> <br />***************************************************** <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />-. /' <br /> <br />COMPANY ~V\(..s.. lWL l\.l~~S. <br />T OR REGIST # p:-e- l...I-:tS If:; {)c;A. <br /> <br />* * * * * * * * * * * * * * * * * * ** ~* *t * * D * * * ~ * * <br />COMPANY ~ r ~ r~ ~ ~ <br /> <br />RT OR REGIST # ~-0cf51q{? <br /> <br /> <br />************************************************** <br /> <br /> <br />COMPANY~~~~ ~ <br />STATE CERT OR REGIST #~ I~~~ <br /> <br />MECHANICAL <br /> <br />SIGNATURE / <br /> <br />OTHER <br /> <br />