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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 />:;J. - J- ?J - o.~ <br /> <br />JOB ADDRESS <br /> <br />rrttnus PMlUf' <br />t56S!{ ~ st <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />(--_(g/3)~.~ ~ q - 404-L/~; <br />PHONE C,elL'::::---:-'--'---. <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # 11--;)& - ~ 1- 0010'" 0 ~1 DO - D I SO <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />[JADDITION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br />[JALTERATION [J REPAIR I1ti"NSTALL <br /> <br />[J SIGN <br />PROPOSED USE: ~L FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />[J MOVE <br /> <br />[J 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 />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />ins+a1L Ale S~H.tm <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <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 />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />~---- <br /> <br />PERMITS REQUESTED <br /> <br />/ 1 <br />~/ :9 q~.... /'/ <br />v~ ./// <br /> <br />--."..---"",., <br /> <br />[J BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br />0 ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br />o PLUMBING <br />~ECHANICAL $ ~~oo.oo VALUATION OF MECHANCIAL INSTALLATION <br />o GAS o ROOFING o SPECIALTY 0 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 AREA[J YES [J NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />e <br /> <br />SIGNATURE <br /> <br />W. J <br />****************************************************************** . <br /> <br />~ cIu./J~/ <br />COMPANY LiP ,; c2.. ;;Z ~ ~f(Jr 6i}s <br />. ~I r <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 />SIGNATURE <br /> <br />*******************************************h)**t*~**~7****/****** <br /> <br />COMPANY U't-YIS Ie <...-{)~a;n~ <br />~ ~ STATE CERT OR REGIST i CAC058575 <br />***************************************************************** <br /> <br />MECHANICAL <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />