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<br />CITY OF ZEPHYRHILLS PERMIT APPLiCA~~V~ <br />BUILDING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />;..15 !{)~ <br /> <br />, <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />I, ~ <br />,~ /.--- I A <br />OWNER'S NAME ., ::/.L-/-:" , )I'r <br />JOB ADDRESS3~ b, S I ---r;;"Re ))~ <br /> <br />PHONE gJ 3. 'Zg 0 - / /t.5? <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />(0 <br /> <br />BLOCK <br /> <br />/r ' <br />SUBDIVISION (..nvntr 1Jt<.f-s <br />{OBTAIN FROM PROPERTY TAX NOTICE\ <br /> <br />PARCEL 10 # <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br />o SIGN <br /> <br />PROPOSED USE: oSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />oMULTI-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 APrROVAL <br />DESCRIPTION OF WORK '~C:l ""? ,4 /J~ ~ 1- i r-. r-i <br />BUILDING SIZE J' ,X ~ () SQUARE FOOTAGE ..d tj (l, <br /> <br />HEIGHT <br /> <br />~' <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (I) 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 />(4)(:;. /6 5. ~,~ <br /> <br />$ <br /> <br />, t( cPt> ' ?? <br /><;- (:) <br /> <br />PERMITS REQUESTED <br /> <br />0J2.C-. <br /> <br /><.f.0,~b <br /> <br />~ BUILDING <br />~ ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />~ <br /> <br />Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION .f" '3 1/5 ~ <br />o OTHER <br /> <br />$ <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />~ FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />.3 // <br />( r) <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES ~ NO <br /> <br /> <br />COMPANY <br /> <br />BUILDER <br />SIGNA;URE ~~~ ~ .e"--'l_ <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />f)~ <br /> <br />ELECTRICIAN <br /> <br />-# r:2~ ' <br />SIGNATURE 0 ",5J- .......~ <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />MECHANICAL <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />