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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 ~- /tJ----O~ <br />-rhOf\o16c~ <br />PERMITTING (4..i~)~'&.O~c:n <br /> <br />OWNER'S NAME S~e..s ~. DQ..(~e.,. \d--ed rJ'c.k.. PHONE <br />JOB ADDRESS 554~ ~+h $~-r~-+- Zech\1f h; lls. , ~L <br /> <br />(G(~u) 5lc. ~ _ <r" 3~ <br />"3 oS'"C-t ~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # ..Jl.~Io.al.OOlD.D'BgO().O~l() <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />r)1ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />PROPOSED USE: 9QSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK 12.p~ rn.,{ f> ~~." 'eLl +0 2..00 CJ....rv....pb--. <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br />~OO <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />AMP SERVICE ~ Progress Energy 0 w~ <br /> VALUATION OF MECHANCIAL INSTALLATIOf J <6 q q I <br />0 OTHER ~_3 <br />0 FRAME 0 STEEL o OTHER <br /> <br />iii ELECTRICAL <br /> <br />o PLUMBING <br />o MECHANICAL $ <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <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 />l~J uJ". ~ YL- <br />SIGNATURE ~---ff <br /> <br />COMPANY K~ clec rnc..aJ I Jilc...... <br />STATE CERT OR REGIST # \ 4~ ~ <br /> <br />ELECTRICIAN <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 />