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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 RECE IVED <br /> <br />/-:;'1-o$' <br /> <br />PHONE CONTACT FOR PERMITTING( <AI~ ) ,St. Q()O}\ <br />- <br />-rho1V\&\.;:) <br /> <br />OWNER'S NAME ", ~K I SCt~b E(2.... <br /> <br />JOB ADDRESS3~Col4 ~~ ~~ ~~lbjll~ <br /> <br />PHONE <br /> <br />FL- 3~';)-,.) <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # _\ \ . ~Io ..a\ ~ 0010' d.D<ooa. 0010 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION o ADDITION o ALTERATION ~ REPAIR o INSTALL <br /> o SIGN o MOVE 0 DEMOLISH <br />PROPOSED USE:~SGL FAMILY DWELLING DMULTI - FAMIL Y 0# OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK Th~TA-l-0 f\JE.,w 1'2.$ PdY\f ()\J.e..rhe.od SeJ"Jlc.t. .t. re..kcL~ ~\ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <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 />PERMITS REQUESTED <br /> <br /> <br />~ <br />~19~ ) <br />// <br /> <br />o BUILDING <br />~ ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />~qS . OUAMP <br /> <br />SERVICE <br /> <br />pa <br /> <br />Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <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 />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br />SIGNATURE l~~ ~ R---. <br /> <br />COMPANY 'Re ese.... aPe :ifl ( II 1. 1:" <- . <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 />