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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 />PHONE CONTACT FOR <br /> <br />DATE RECEIVED 125~ 5 <br /> <br />P~tfcrPERMIT SERVICE <br />1-866-824-7894 <br />Toll Free <br /> <br />PHONE <br /> <br />OWNER'S NAME t r //113 tJ,ai Ie; <br />fJ!} f'/k IJr/fe <br /> <br />LEGAL DESCRIPTION: LOT(S) ~oS- <br />v-Y-cJ.('-02/- (}cJ:)-()- tXJ()(X)-JOSO <br /> <br />JOB ADDRESS <br /> <br />3S/7 <br /> <br />SUBDIVISION ElXArlJ II' ;JOI/tH.. <br /> <br />BLOCK <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: Q(NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br />PROPOSED USE: ~SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />1;< X 3 ;;2 <br /> <br />LaI'1~, <br />, <br /> <br />( Shrt/f j e <br />J ~ t../ <br /> <br />...t... <br /> <br />h::.-<ftt "- IA 1. 'If";" ) <br /> <br />BUILDING SIZE <br /> <br />/:J.Jt32 <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT Si?t!. ;:J( 4 Ie. C <br />" <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 />- o~ <br />J~) - ~LjJG <br />35,.- ~c ELf2..C... <br />52. .;~ ?~0. <br /> <br />~ BUILDING <br />~ ELECTRICAL <br />00: PLUMBING <br /> <br />$ <br /> <br />/~, 000. '.JI <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <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 AREAD YES 0 NO <br /> <br /> <br />SIGNATURE <br /> <br />COMPANY t?~~ <br /> <br />~..::::~...........:~~~~.:~~~.~~.~~~::~.:.......... <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />I'" <br /> <br />~6~ <br /> <br />COMPANY tI~ <br /> <br />ELECTRICIAN <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br />SIGNATURE .z.-e- ~( $~ <br /> <br />COMPANY t7~ <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 />