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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 />t2 ~/t7 5 <br />DATE RECEIVED ~ <br /> <br />PE~AS'CrrPERMIT SERVICf: <br />1-866.824-7894 <br />Toll Frp.e <br /> <br />OWNER'S NAME <br /> <br />IZOflt2-! J ;C:r~.scJ m ajJ <br />IJ ~ t(). /k;/' / Z O/l .s <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />3 7(P/~ <br /> <br />6/ j/ cI <br /> <br />PARCEL 10 # <br /> <br />3Y -clS"- cJ-/ -0090 - OCJ1X) - 0&3 () <br /> <br />(OBTAIN FROM <br /> <br />CruA cI 'fI()r/2~I7S <br />f'1l 4-u / <br />PROPERTY TAX NOTICE) <br /> <br />LEGAL DESCRI PTION: LOT (S) (P J of- &, f/ <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />tXALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED <br /> <br />DSIGN <br />USE:yqSGL 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 />HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />(II <br /> <br />Cfi./1 /)() /' f <br />I <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />o 9~" <br /> <br />HEIGHT 9 <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 />BLVb. <br />c=:f>LJ:L . <br /> <br />'\ ~-c.. <br />J2~ , <br /> <br />PERMITS REQUESTED <br /> <br />CfBUILDING <br />o ELECTRICAL <br /> <br />$ <br /> <br />.,J, t2S"O, 0<1 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL <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 />~r~-- <br /> <br />COMPANY <br /> <br />/)()/Le1JlUl-l r - Ro/?o/' P./~cA/1I. a/J <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br /> <br />...~....................:::::::.~~.~:~..~ <br /> <br /> <br />STATE CERT OR REGIST # <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 />