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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 STH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:S13-780-0021 <br /> <br />DATE RECEIVED <br /> <br />311/t! S- <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAM~ 1;;f:t~..4Lt, lv\c'~ ~V1'C,,\ <br />JOB ADDRESS t{~ ' __ '5 ~~C0l~~ ~~~)~;:~71I~ l~(t l uT <br /> <br />PHONE L <Q \-S) Ice,) ,:2 -- ,3 '-ofT [' <br />. Aft~ 3 :00 <br />~~c}Q6y+- ki YlJ ( . aA-z-H1\ \S <br /> <br />SUBDIVISION <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # I;<-;?L.QI- 003<J -()D.QOO "'008() (OBTAIN FROM PROPERTY TAX NOTICE) <br />" r <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />):qADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />)i.\OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK Cr(~GZPOGL, CtoSGQ Ie I;)E l~:~erl A'S AA) L\oO\II/\I\.)A~ <br />l<-O c "->- <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 />PERMITS REQUESTED <br /> <br />r'~ <br />~l.. <br /> <br />" <br />'7 r . ~ 'j <br />&1/ 50 <br /> <br />i'3L))6. <br /> <br />-....c. <br /> <br />~B~DING <br />~LECTRICAL <br /> <br />$~bO ,(f'1 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OT HER <br /> <br />TYPE OF CONSTRUCTION:~BLOCK <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES .IS{ NO <br /> <br /> <br />BUILDER <br />SIGNATURE H Ll & t2-TO A.'V'l' rJ--S <br /> <br />COMPANY <br /> <br />AlIA <br /> <br />~~ <br /> <br />STATE CERT OR REGIST # <br /> <br />MIA.. <br /> <br />J' VJ ~ ~.~*************************************************************** <br /> <br /> <br />~ ELEC~R~~ COMPANY <br />\ U ' <br />~~. /v(~A4- <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 />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />