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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 ~7/- jJ 1- (, 5' <br />DATE RECE IVED - _I <br /> <br />tJ..b brS :fe vI nS(PHONE CON'rACT FOR P'RMITTIN~ q /1- / (131 <br />OWNER'S NAME' \" hu{"a/J Ve 1') (t {iA <br />, <br /> <br />JOB ADDRESS if; (7'5/ <f/IJ--) t- J2)j I/e/ ?; 1~~ly(IL ((<J I t=t- <br />SUBDIVI S ION (~{ 11i1. L/ Cl?)"'\ ''1. _{t,e <br /> <br />PHONE <br /> <br />'- , f\ 21 I . <br />,!VI. - C"""'U <br />':;:5 'j~!(j <br /> <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />"'S-P( f~ll( {0:)ill /{/{jtt( f;JI5::if ,,1. <br />/ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />~IGN <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br /> <br />~~MMERCIAL <br />( <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />oMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />'j <br />DESCRIPTION OF WORK ~ l0.LJ.t.l-U C Nt ,'(L., jk;~lL:i [)\ f{~/;d'>L V <br />" , . ,/ <br /> <br />BUILDING SIZE ..9 (51 5r'~k/rk 5~ SQUARE FOOTAGE .,J tV{ <br /> <br />, ( f ;} <br />I /1 / . t, _ ----r: /J <br />I ~Ir:t I.}? (,) ',,-_N') ,j't ,(z,(. ~ <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 />1\-l)...6vUf1.-V . 17{\-J ?v))Z)') I; ') 71ft <br />r I ,,'-'/' I J <br />','7- > r \ . PERMITS REQUESTED <br /> <br />A~G3UILDING $~ J (1 V [1 <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />_ ,-0 <br />'7 I ..... <br />'7 ) - <br /> <br />''? S....... ('/~ <br /> <br />)~ LI) ( <br /> <br />~ ., (" <br />" Ln- <br />, t-- ' <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />,)rfELECTRICAL <br />/ 0 PLUMBING <br />o MECHANICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <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: 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 />BUILDER <br />SIGNATURE~I\\ ciJ"J..Llf ,-'y~' <br /> <br />,1 1....." <br />, .;-J.,6"/l1\..-1 <br />, 1"" <br />! / <br /> <br />COMPANY <br />STATE CERT OR REGIST # D:C - 6 u J ;;}'::;<j- ) <br /> <br />ELECTRICIAN <br />,t, -' <br />'.< i" ',tJ t I ! <br />SIGNATURE I IJ_ ..._~ <br /> <br />****************************************************************** <br /> <br /> <br />COMPANY Q/Jh/>)(() /J ! l;e- <br /> <br />. <br />~'i- <br />- - <br /> <br />1\ _ ...v- <br />++~f ~/I <br />'J 1- <br /> <br />STATE CERT OR REGIST # ;'(- /Ud ~J !S~~-.) <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 />