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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 B~s St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />r (lUl VlI1lrd1 <br />3g034' ~Ld ~ ~ <br /> <br />OWNER'S NAME <br /> <br />PHONE 7 f3 - <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL ID # 35 -;?5;)J - 0010 - 00000 - OO3[J <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />[J ADDITION <br /> <br />ID1G..TERATION <br /> <br />[JREPAIR <br /> <br />(] INSTALL <br /> <br />[J SIGN <br /> <br />(]MOVE <br /> <br />[J DEMOLISH <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />[JMULTI-FAMILY <br />(] INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />clttvr.~ ~ ar-J.Lns,lnj UJt?f <br /> <br />SQUARE FOOTAGE HEIGHT <br /> <br />BUILDING SIZE <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 /> <br />(] BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />(] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />[J W.R.E.C. <br /> <br />(] 7LUMBING <br />hi MECHANICAL <br /> <br />$ <br /> <br />/100.00 <br /> <br />[J GAS <br /> <br />[J ROOFING <br /> <br />(] SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[J OTHER <br /> <br />TYPE OF CONSTRUCTION: (] BLOCK <br /> <br />[J FRAME <br /> <br />[J STEEL <br /> <br />(] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES (] NO <br /> <br />P<;>~~9W9,~'i:i~E9l:rJ.~9N <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <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 />SIGNATURE <br /> <br />..................~~........~~;;;;... "is7"'Ar!{:" <br />..... ~.. fL. ~~;....... .::~:: .~::: .:: .":.~:::.:. ~~::.~.gs 1 <br /> <br />MECHANICAL <br /> <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />