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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8ft St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 6~ I / ,~ <br />DATE RECEIVED Jt^( Jt t!1r <br />PA-SCo PcRMlT SE"RIfI< <br />PHONE CONTACT FOR PERMITTING l-<gfC(.,-g).l.{-789tf <br /> <br />\ <br />) <br />, <br /> <br />E / (Lt~ Cf- fide m ~Z <br />0J>78 jj)L-AAte '. /"k/~ <br /> <br />LEGAL DESCRIPTION: LOT(S) /~..,. /3 BLOCK '-/9 <br />11- ~~ -JI- ()()/() - 01./900- O/~ <br /> <br />OWNER'S NAME <br /> <br />, PHONE <br /> <br />JOB ADDRESS <br /> <br />WORK PROPSED: oNEW CONSTRUCTION <br />oSIGN <br />PROPOSED USE:~SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />tit ADDITION <br />o MOVE <br /> <br />SUBDIVISION U-lj Of ZRPLI/I~IJ!r <br />c:: ~ ~ ~ <br />(ORTAIN FROM PR PERTY TA NO ICF. <br /> <br />PARCEL ID # <br /> <br />oALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <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 />o RESTAURANT <br />. <br /> <br />DESCRIPTION OF WORK a...d '- L .) / oi..- <br />I <br />I tl ~ ~IJ I <br /> <br />& HEALTH DEPARTMENT APPROVAL <br />~ it dIU IcL'~rJ-</ I <br />~f') OP J <br />SQUARE FOOTAGE Ol (1 (J <br /> <br />HEIGHT <br /> <br />BUILDING SIZE <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 />~ BUILDING <br />o ELECTRICAL <br /> <br />PERMITS REQUESTED <br /> <br />f\JlfJID ~f~~ t/ <br />~\.lL4-~f <br /> <br />$ /tJ. em. ()} <br />, <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 />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <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 AREAo YES 0 NO <br /> <br />SIGNATURE <br /> <br />t~/C CU'r\ Q <br /> <br />C~TOJt;i~'SECTION <br />~ ,-~ .~ "'.~- ..' _.- _: ":-,:,';-, ._:':_''-A~<>.'.,,,.,'~:' ,';,,:_ >~.~:. .; _.;";". ..._: ~', ..:.' '.:, ; <br /> <br />COMPANY /;OM ot.JJlJlr <br /> <br />BUILDER <br /> <br />c 11) Q/,;V}V? _/&- . <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />, ELECTRICIAN <br />SIGNATURE t'11 CL'",,- C Y11 Ml/1V0>1 <br /> <br />COMPANY <br /> <br />hOIAL OIVMr <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PWNBER <br /> <br />eyLlU"'- C ~1l/7VVj1 <br />( <br /> <br />COMPANY <br /> <br />h 0 /)...R. ()tU~ <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />N D ()1 tL.-1f /TN I C/fL <br />t.~:5 F ELE crr< Ie !fE77TE K <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />