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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 />d..// if /'~: )- <br /> <br />. <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME~~..J-r~,~ JJ1<L.. PHONE ~{3...7'f';;-O'i'~s <br />JOB ADDRESf ;g'l'-!c;:7 ~e.-I cJ:l~ ~, <br />LEGAL DESCRIPTION: LOT (S) 0 6".3 V BLOCK~ SUBDIVISION 0 l ~ <br />PARCEL 10 # ,3cJ-c:;(5-.;;.J - 0(.30 - ~-t5 530 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~EW CONSTRUCTION <br />OSIGN <br />PROPOSED USE:~ FAMILY DWELLING <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 /> <br />0# OF UNITS <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />dJa ~~COMMERCIAL <br /> <br />~ c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />C-0- ~ (""'.t / J' " i . 11 <br />DESCRIPTION OF WORK n ~ ..::::Jt:J e.. :\<P,......w'L.l y ('e-..C ( cr~<!.. C- <br />J I; / I~ 'I-(?-- - "PO i......~ _, I f-4-. <br />BUILDING SIZE '7'-7 41( )(3C/ R '( SQUARE FOOTAGE I 8'.;l:.d" HEIGHT <br />. , <br /> <br />o INDUSTRIAL <br /> <br />o SWIMMING POOL <br /> <br />rg/ <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 />~LDING <br />~CTRICAL <br />~MBING <br />~ANICAL <br />o GAS ~FING <br /> <br />$ <br /> <br />PERMITS REQUESTED <br /> <br />115, Ch.~, cj:) VALUATION OF TOTAL CONSTRUCTION <br />O(~ <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />$ s..~OO,OC) <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />,?~61 <br />t . <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: ~LOCK <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 <br /> <br />~ <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # eJle.- 035/ L~~ <br /> <br />********** ** ***************************************~**********~ <br /> <br /> <br />ELECTRICIAN c.b ~ ~. j <L-/ COMPANY c!!-ozJ ~ . <br />SIGNATURE ~u ~-~ - - STATE CERT OR REGIST t ~ tfi)rtf-59/ <br /> <br />PLm<BER ;***~*;*~*~:*:~*~**~*::::::~~*Z*~*i~*\ ~~ <br /> <br />SIGNATUREr.::l:2.~ .- STATE CERT I ~6&() <br /> <br /> <br />******************************************* <br /> <br /> <br /> <br />MECHANIC~~ <br />.,. 0 /:\ <br />SIGNATUR ' STATE CERT OR REGIST # f..V <br /> <br /> <br />OTHER *****:****. ************-:-*******:::::::*~*;:::~~~ <br /> <br />STATE CERT OR REGIST #~. Is:J. S-SLJ5 <br /> <br />COM PAN <br /> <br /> <br />