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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 '/.< '" ) ()S- <br />PERMITTING '7/tf-t.fZ. 71 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />z., <br /> <br />BLOCK <br /> <br />PHONE ~5Z) )'2"7 - 0 cf73 <br />-z.-t-IILLS. ~t-.. 3'35t// <br />.. , , <br /> <br />SUBDIVISION51t,VEt< ~f<51JIuA-/E <br /> <br />OWNER'S NAME 1)lftJlV u) :rbflt-..YJ,'ON <br />JOB ADDRESS ;; 7'-/', ~ 'p/(;(<t; 'J'IS 14/ U S At/E". <br /> <br />PARCEL 10 # OJ - 2~ -2..( - otl2.i) -(Jot (}u ~ 6 01. (.) <br />/ {)ZW <br />WORK PROPSED: ~NEW CONSTRUCTION o ADDITION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br />/ <br />PROPOSED USE: 6rSGL FAMILY DWELLING <br /> <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 />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK ~ilJ tR(..t r/yV1/t. y PWc{A~/AJ (.;. <br />rCl I ~ L) /4) I{ <br />BUILDING SIZE ~-I )/~~~ SQUARE FOOTAGE <br /> <br />Zt3 , <br /> <br />HEIGHT <br /> <br />r' <br /> <br /> <br />ATTACH <br /> <br />PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, <br />FORMS. <br /> <br />~~ <br />~ <br /> <br />PERMITS REQUESTED <br /> <br />/ <br /> <br />/,00 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />3 ~31 <br /> <br />IB""fLECTRICAL <br />~LUMBING <br />~CHANICAL <br />o GAS ~OFING <br /> <br />Zoo <br /> <br />AMP SERVICE <br /> <br />~progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL <br />o OTHER <br /> <br />ENOllvsE <br />INSTALLATION 0 'RED PL <br />~Tr:;.". ~ <br />. .J'..af ..., <br />-~c <br /> <br />pO <br />$ :3, 500,- <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />~RAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~O <br /> <br /> <br />SIGNATURE <br /> <br />/7 / 11 /~ ~/OC<J.::J'JH,uSo,U <br />~ ~ COMPANY P <br />.. =.... <. *......... *... ~.... :~:~~. :~~~. ~~. ~:~::~.:..~.. ~~. ~ ~;;;; ~~ <br /> <br />d;20'/' <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br />SIGNATURE 4h ~~ <br /> <br />COMPANY~Q. PAt.. crle.~~"~ <br /> <br />STATE CERT OR REGIST # <br /> <br />IY 40, <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br /> <br />COMPANY t:o/6y ,JaYI1e5 fI~" ItJG <br />STATE CERT OR REGIST # CFC,}tfl 6 '3/.7 <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />****************************************************~*** <br /> <br />COMPANY 5 () /V ~y -:; <br />~ t1A 60 <br /> <br />STATE CERT OR REGIST # <br /> <br />IS'-t~! <br /> <br />MECHANICAL <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />;' <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />