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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 RECEIVED <br /> <br />~~5 <br /> <br />PHONE CONTACT FOR <br /> <br />PEPfS~ PERMIT SERVICF <br />1-866-824-7894 <br />Tnll Frpp <br /> <br />PHONE <br /> <br />OWNER'S NAME <br /> <br />[!/iJRr <br />JJ~/ <br /> <br />L R.J belt r <br />fj.€)1 Let u. <br />~q <br />(pl-c).(p -J/ - dJJ() - ()()O<X)-o!o90 <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION [ruM/a! "10/$ <br />R P IUfOr! <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL 10 # <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br />o SIGN <br />PROPOSED USE: ~SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />OALTERATION <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 APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />r()OA <br /> <br />eviL 110.4 f 0" eu.e.J1 rrx;/?1 <br />I- \J ~ d _ 11,_ h <br />SQUARE FOOTAGE ~ l~r <br /> <br />j//~q/ 0(/(~ <br /> <br />v <br /> <br />BUILDING SIZE <br /> <br />9'J f (..3 <br /> <br />HEIGHT <br /> <br />PERMITS REQUESTED <br /> <br />& (1) SET ENERGY FORMS. <br />frS, -..,0 <br />1~:> 5-, <br />LJ.'- .j~ <br />. T). <br />7r ...-~ <br /> <br />~))G <br />j): L~ <br />V't\tx A, <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~ BUILDING <br />tf ELECTRICAL <br />t?LUMBING <br />~ MECHANICAL <br /> <br />$ <br /> <br />r:) 7, l/(jJ. 00 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <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 />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY (.. <) Uk. o1c.----te A-I UhA;nLLj,...-..-' <br /> <br />SIGNATURE <br /> <br />%1 ([e~ 'f-! !~ <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRIC'Le <br />SIGNATURE :~e ~ <?P' <br /> <br />COMPANY <br /> <br />C. rCLIA ~:( <br /> <br />E/~cfV'lC- <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />~~b'~ ;~/t <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />** * * * * * * * * * * * * * * * * ** * * * * * * * ** * * * * * * * * * * * * * **A * *** ** * * * ~ *** * * * * * -Ie. <br /> <br />COMPANY aft. r '5 / rtJ,pa.~Gc;<;;. lI-j4-; C. <br />{f , <br />~:~ ~/~ STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />