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<br />JOB ADDRESS
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<br />NAM~h /) '({\tL /J \) a ,'Vt .~ /1
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<br />BLOCK SUBDIVISION J~CI'\J'-'l C o.hIl::)l-~~ ....
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<br />{/~..c v1,} >-) (OBTAIN FROM PROPERTY TAX NOTICE)
<br />
<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION
<br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 () '. ,-
<br />813-780-0020 FAX: 813-780-0021'J'- JLf-()L.)
<br />DATE RECEIVEIL--- -
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<br />PHONE CONTACT FOR PERMITTING 7 - j D <3 I
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<br />PHONE ('~{JL) -, '7 / ;;;0
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<br />OWNER'S
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<br />LEGAL DESCRIPTION: LOT(S)
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<br />PARCEL 10 #
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<br />WORK PROPSED: DNEW CONSTRUCTION
<br />~SIGN
<br />USE: DSGL FAMILY DWELLING
<br />J(cOMMERCIAL
<br />
<br />o ADDITION
<br />
<br />DALTERATION
<br />
<br />o REPAIR
<br />
<br />o INSTALL
<br />
<br />o MOVE
<br />
<br />o DEMOLISH
<br />
<br />PROPOSED
<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 />o RESTAURANT
<br />
<br />DESCRIPTION OF WORK \ '" ~~(U ,
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<br />BUILDING SIZE \ ,~) \\t;\1-(l'j
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<br />& HEALTH DEPARTMENT APPROVAL
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<br />
<br />SQUARE FOOT~GE (z I o(;Z 'HEIGHT
<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 />~ L~~N PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
<br />\,~ Y~1 PROPERTY ~WRVEY REQUIRED FOR ALL NEW CONSTRUCTION.
<br />2 G ,I.( 0 rf.-~,l\' )J2.K :::--:-
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<br />/1t\ )1 i . PERMITS REQUESTED
<br />
<br />$ ,O,(f.,{) .cE.-, VALUATION OF TOTAL CONSTRUCTION
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<br />HBUILDING
<br />~LECTRICAL
<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 />
<br />o MECHANICAL
<br />
<br />$
<br />
<br />VALUATION OF
<br />
<br />MECHANCIAL INSTALLATION :J{-L/(10 /
<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 AREAD YES 0 NO
<br />
<br />
<br />COMPANY
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<br />0.01.0.,) rLe
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<br />SIGNATURE '-f'U i_,,~~ -Ct(
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<br />
<br />STATE CERT OR REGIST # (;c ~ Ot')o.~1S-5-<o)
<br />
<br />SIGNATURE
<br />
<br />********************************************~********************
<br />
<br />
<br />COMPANY \Juv (--II 0" .'~ I~i eir I c-
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<br />\,,' -1,.- "'.}(vi ,,-'V;1C/L/' STATE CERT OR REGIST # >C..()/'!() c-,:,:;:::,j
<br />
<br />ELECTRICIAN
<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 />
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