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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 />DATE RECE IVED
<br />
<br />cJ- - ~ - t),-::;-
<br />
<br />OWNER'S NAME
<br />
<br />
<br />vlj
<br />
<br />PHONE CONTACT FOR PERMITTING
<br />
<br />~~z~
<br />
<br />L...J {;'2.rfJ I-{ 0 (...l..Q~ 1-f()f?/rl?
<br />
<br />JOB ADDRESS
<br />
<br />LEGAL DESCRIPTION: LOT(S)
<br />
<br />
<br />BLOCK
<br />
<br />SUBDIVISION
<br />
<br />PARCEL 10 #
<br />
<br />(OBTAIN FROM PROPERTY TAX NOTICE\
<br />
<br />WORK PROPSED: ONEW CONSTRUCTION
<br />o SIGN
<br />PROPOSED USE:~GL FAMILY DWELLING
<br />o COMMERCIAL
<br />
<br />P(ADDITION
<br />o MOVE
<br />
<br />o ALTERATION
<br />
<br />o REPAIR
<br />
<br />o INSTALL
<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 APPROVAL
<br />, /
<br />DESCRIPTION OF WORK f'NCLOS~ 12..1x... (2- ROQi-'( IN IF><'IS'f],.,J C;; ~
<br />BUILDING SIZE J 2..1 X. I 2.( SQUARE FOOTAGE /4</ Fr 2-,
<br />
<br />~~T.
<br />
<br />HEIGHT ~!.-IO'~ 7!../oY2:.
<br />EX.,STI,.Jl> SL.c p"..J ({ ReoF
<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. 7, )-, ,~.~
<br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
<br />
<br />)( BUILDING
<br />~LECTRICAL
<br />o PLUMBING
<br />o MECHANICAL
<br />
<br />~ bCiu ?'"
<br />$'~l,~
<br />
<br />PERMITS REQUESTED
<br />
<br />j)~.
<br />;ifO. .~0 EJ-liL.
<br />~
<br />
<br />AMP SERVICE
<br />
<br />o
<br />
<br />Progress Energy
<br />
<br />o
<br />
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />$
<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 />Jiil.. OTHER ALv t--t l
<br />
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
<br />
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<br />
<br />BUILDER ~
<br />SIGNATURE~' . ~ ~
<br />
<br />COMPANY/' OWI/.Jt.::--t<..
<br />
<br />STATE CERT OR REGIST #
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<br />******************************************************************
<br />
<br />ELECTRICIAN ~~
<br />SIGNATURE ~. '
<br />
<br />COMPANY/~W},j ere
<br />
<br />STATE CERT OR REGIST #
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<br />******************************************************************
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<br />PLUMBER
<br />
<br />COMPANY
<br />
<br />SIGNATURE
<br />
<br />STATE CERT OR REGIST #
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<br />******************************************************************
<br />
<br />MECHANICAL
<br />
<br />COMPANY
<br />
<br />SIGNATURE
<br />
<br />STATE CERT OR REGIST #
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<br />*****************************************************************
<br />
<br />OTHER
<br />
<br />COMPANY
<br />
<br />SIGNATURE
<br />
<br />STATE CERT OR REGIST #
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