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<br />.. <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICAT~U~ <br />BUILDING DEPARTMENT 5335 B~H at, Zephyrhills, FL :33542 <br />813-780-0020 FAX:B13-7BO-0021 <br /> <br />DATE RECEIVED <br /> <br />d - /q..OS <br /> <br />PHONE GONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />Jqc~b <br /> <br />U a r, c(,L,...., J. .e..er. <br /> <br />PHONE <br /> <br />5' I J - 7 y 2 - -f ? f.J <br /> <br />JOB ADDRESS ?;r? I d <br />- <br /> <br /><-/ J.<) ,I U F <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY.TAX NOTICE\ <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br />PROPOSED USE: []SGL FAMILY DWELLING <br />[] COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />[]MULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />[]. OF UNITS <br />[] SWIMMING POOL <br /> <br />[] MOBILE HOME <br />[] OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APpROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />/U~7. <br /> <br />BUILDING SIZE <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 /> <br />uP <br /> <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />PERMITS REQUESTED <br /> <br />~ BUILDING <br /> <br />$ <br /> <br />L.j r;/bQ. t--O <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] Progress Energy [] <br /> <br />W.R.E.C. <br /> <br />[] PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />BUILDER j'. /",./.l.. <br />. 1( / ('- <br />SIGNATURE ~ *-:::...,.,-,{t--./ n.'~ "2':........... <br /> <br />../' <br /> <br />STATE CERT OR REGIS'r . <br /> <br />****************************************************************** <br /> <br />/ <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <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 />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 />