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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 />I fz!o5' <br /> <br />, <br /> <br />OWNER'S NAME .J..>,! ~) IV C L I-l 1\/ ~ EN 0 of( r e R.. <br />JOB ADDRESS "3 r:;'S 10 LA IV';:: I VlJt/ Ff 1/. <br />LEGAL DESCRIPTION: LOT (S) I 3 L..j BLOCK <br /> <br />PHONE CONTACT FOR PERMITTING <br />C~" <br />PHONE 7/1- 626 ~ 3K2(J <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />[JADDITION <br /> <br />[JALTERATION <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />[JSIGN <br /> <br />[J MOVE <br /> <br />[J DEMOLISH <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />[JMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J # OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />[J OTHER <br /> <br />BUILDING SIZE <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />WORK ErJc/os-E' :J .)1 Dee; Ft11t %,e A"1E /cgdlh <br />I. I <br />tLY/2- <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF <br /> <br />RESIDENTIAL: <br /> <br /> <br />PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br /> <br />IF SIGN <br /> <br />PERMITS REQUESTED <br /> <br />~)~ <br /> <br />[J BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br /> AMP SERVICE [J Progress Energy [] ~R.E.C. <br /> ~L~ .;=> <br />$ VALUATION OF MECHANCIAL INSTALLATION <br />o SPECIALTY D OTHER <br /> <br />[J ELECTRICAL <br /> <br />[J PLUMBING <br />D MECHANICAL <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />D FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES [J NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />.~ () ~1' <br /> <br />f <br />SIGNATURE <br /> <br /> <br />STATE CERT OR REGIST # <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 />****************************************************************** <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 />