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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 ' ~I/O~ <br />DATE RECEIVED , <br /> <br />PHONE CONTACT FOR PERMITTING tJf~- 267- '}~() 'l..- <br /> <br />OWNER'S NAME <br /> <br />\tv ILtN/~(E:lJf <br />b/~f6 IC7tJ, $7. <br /> <br />PHONE ~/1z-L;31- g~1fr <br /> <br />JOB ADDRESS <br /> <br />ZqAYJ-Ad!.s <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />33$~z-. <br />SUBDIVISION af/J~r <br /> <br />. rJ;l'-Uze Sot <br /> <br />PARCEL ID # <br /> <br />OZ-Z,b- 2(-- (j ,( " <br /> <br />66CO -o~ r:o <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />[JADDITION <br /> <br />[JALTERATION <br /> <br />[J REPAIR <br /> <br />rtINSTALL <br /> <br />[J SIGN <br /> <br />[J MOVE <br /> <br />[J DEMOLISH <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />[JMULTI - FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />12"/!l- It-f'J1IH liD 6t-S ~ M G PJrJ4E. 7D ~ D 5 ""$1lIt . <br /> <br />2- 11.s <br />(,0}5 <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED, ~J <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ~~ .~~ <br />,J'L, <br /> <br />ENERGY FORMS. <br /> <br />8LDG. <br /> <br />PERMITS REQUESTED <br /> <br />[J BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[J ELECTRICAL <br />[J PLUMBING <br />[J MECHANICAL <br /> <br />AMP SERVICE <br /> <br />[J Progress Energy [J <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: [J BLOCK <br /> <br />[J FRAME <br /> <br />[J STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES [J NO <br /> <br /> <br />SIGNATURE <br /> <br />I .. f/'Ik U~yr"- ().Fr- <br />COMPANY GO <br /> <br />STATE CERT OR REGI ST # C }ZL D';'~ f.o R <br />L 1 Y - () I :?>J1J <br />****************************************************************** <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />/J~* * * * * * *11* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *; * *~* ~:5 * * I~* C: *~ / ~ <br />OTHER/ II.. " COMPANY L---I Nt::: - . <br /> <br />SIGNATURE )JtlI1/(~ .', STATE CERT OR REGIST # ,G /ZLof"9ttL g <br />(71 u( 3,113 <br />