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<br />CITY OF ZEPHYRHILLS PERMIT APPLICAT~U~ <br />BUILDING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE C;ONTACT FOR PERMITTING B I ~,.. Zb 7 -'?if6 7/ <br /> <br />OWNER'S NAME {V\f9DL('1'?1, JZI(J\-~ <br />JOB ADDRESS '1 Z~b LnNptJ vB(., py-. <br /> <br />PHONE ~r>-78J-Z~z3 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />1.~' Z,",Z( ,..-lfl) $1)- 6 0660- ()~~ b <br /> <br />BLOCK <br /> <br />SUBDIVISION A4zk..: Vi Ih-r <br />(OBTAIN FROM PROPERTY.TAX NOTICE\ <br /> <br />PARCEL 10 it <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />Q(INSTALL <br /> <br />o SIGN <br /> <br />PROPOSED USE:~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />O. OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL <br />~ J2.- VII I/J))~ IfJS {'vb WIilVl'IE 11> tu v~il' D f.( N1N '1 !, <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. JI <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION~_ ~ <br /> <br />. 75.~~ <br />PERMITS REQUESTED <br /> <br />ENERGY FORMS. <br /> <br />().;j)G, <br /> <br />~ BUILDING <br />o ELECTRICAL <br /> <br />372b.n <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <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 />COMPANY <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST . <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />ELECTRICIAN <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 it <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />MECHANICAL <br /> <br />STATE CERT OR REGIST it <br /> <br />OTHER .:-i::W~j,:J;*******w*******~~~::;:z;~~rWimG**(i~ I~ <br /> <br />SIGNAT~\,L ~~ ' STATE CERT OR REGIST i G'jZLO~~* <br />L'IV _ 0\3\\3 <br /> <br />SIGNATURE <br />