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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 arR St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />1/3//05 <br /> <br />I <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME (;-A/lA.J) If "1'\( "'\.....,.u <br />JOB ADDRESS .57<1</3 G-. , ( n.v<. <br /> <br />PHONE <br /> <br />Lv( /)lV <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />{OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />oSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: oSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />~ILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />M-H. :5&f <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 />1-' +-""' J- (;1r1.. k I v"'r'~y <br />~~I A-GP L/" <br /> <br />o BUILDING <br /> <br />$ <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 <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 AREAo YES 0 NO <br /> <br />~[.~~2~~~~:~~~~ ~:'=~_:~:_, ~~~_:~~~-~~:~~~=~:~.~ ~~.:~' ~~- .:_.' ., - p .~. ... - ~~'. ~- _::_:~.:::~-~~ ~..~._..'-' .:~.~~~~-~'~' ~~:::'.~~~~~:~ <br /> <br />SIGNATURE <br /> <br />W'-7--~JJ <br /> <br />COMPANY f'I......1T e..,-.,f/ <:. fJ <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # <br /> <br />**************************************************************~*** <br /> <br />ELECTRICIAN <br /> <br />uJ~~)j <br /> <br />COMPANY <br /> <br />/J<::.<<e... <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY LJu.llc"'-hi-IJ <br /> <br />SIGNATURE <br /> <br />t.tJ ~ 6'~ <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />/lc::.~ <br /> <br />SIGNATURE <br /> <br />vJ"7-- L1~ <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />