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<br />(\ '.' <br />'_Q.\ \Q \0.< <br />(~J ,\; \ cQ., . <br /> <br />~ <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 89 St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />/1-;)/3 ~oy <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME_f-.a (). ~ ,\t (\\12-< -\ \ Q~ ") U C . PHONE ( q LX \\ LX <i~ ~ CJl 70 <br />JOB ADDREss1'6~S Go..\\ ~Vd') t.~~\rV\\\\~j i\ 33:5llO <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL ID # 34 - rs- 2..1-60 \t)- C) \1C() --{Y){)CJ (OBTAIN FROM PROPERTY TAX NOTICE} <br /> <br />WOR~ PROPSED: adNEW CONSTRUCTION <br />o SIGN <br /> <br />o ADDITION <br />o MOVE <br /> <br />OALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE:OSGL FAMILY DWELLING <br />IXlCOMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK -I0\-Q.:\\ 0\ Ccxn90~ion <br /> <br />BUILDING SIZE .-l<t,' 'J... 10 (') , SQUARE FOOTAGE ~ HEIGHT 1./3' <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 />mJ BUILDING <br />m ELECTRICAL <br /> <br />$ <br /> <br />,[1, ~OO <br />lea <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />IXJ PLUMBING <br />181 MECHANICAL <br /> <br />$ <br /> <br />4\ Ljoo <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />1 <br />{1''3~~ <br /> <br />o GAS la.ROO FING 0 SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ~ BLOCK 0 FRAME <br /> <br />J551 <br /> <br />Ii( STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />o NO <br /> <br />BUIlDER i . f:ide~~:;:~VYJ~ '~~nt ~~;h. <br /> <br />SIGNATuaE:.--...t2A_~~D, /'0--- STATE CERT OR REGIST # (2,{!{l.O I{)q ~"1 <br /> <br />ELECTRIC <br /> <br /> <br />****************~***************************** <br /> <br /> <br />: COMPAN~VIC~1tr{I~.~t(iC. <br />STATE CERT OR REGIST ##- (}f!. t"d"J l ':\ l{l <br /> <br />PWHBER <br /> <br />*************************************************** <br /> <br /> <br />COMP~nni~ l Vllh~i% f\\LlYOi'}j , <br />STATE CERT OR REGIST # C-1{I- \ 4- L~ I nO t:- <br /> <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />l <br />