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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 />ll,t/o,,> <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAM~r? {C H A R 0 LJ OD 0 W DR T I-{ <br />JOB ADDRESS . 5 (; 6 9 177:1, 5 r <br />LEGAL DESCRIPTION: LOT(S) I ~ .3 L-f BLOCK <br />PARCEL ID # 11-;)6-)I-OOIO-lit.lOD -00 <br />WORK PROPSED: ~ CONSTRUCTION o ADDITION <br />O GA-RItGE:.. <br />SIGN 0 MOVE <br /> <br />PHONE <br /> <br />7g 3 -;) I 6 6 <br /> <br />~ H/L-'-~ <br />1/4 <br />It <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI - FAMIL Y <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 />BUILDING SIZE <br /> <br />c AI1Ace- <br />-;)D X -:24 <br /> <br />SQUARE FOOTAGE <br /> <br />4 y; () <br /> <br />. ,/ <br />HEIGHT ,;).. <br /> <br />DESCRIPTION OF WORK <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 ENGINEER~ PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR/ALL NEW CONSTRUCTION. ,;) t~ a?lD6, <br /> <br />Y7ir14) i~N. /2, ~"" 1i)4-L'-'ltlllr' -...u~_ <br /> <br />PERMITS REQUESTED ~~ <br /> <br />o BUILDING <br /> <br />$ScJtJO <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK ~RAME <br /> <br />FINISHED FLOOR ELEVATIONS 'J Ilrt 6/JuE: <br />(J (?IV EWA V'" <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />~ <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br /> <br />SIGNATURE <br /> <br />.~ <br /> <br />COMPANY 5 E /-.. P (<f1~) <br />7{/ ~ STATE CERT OR REGIST # <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN ~ ~ . /) "'If:::-J <br />SIGNATURE t~ <br /> <br />COMPANY <br /> <br />tf7A/Jt....ut <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 />****************************************************************** <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 />