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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH' St:, Zephyrhil1s, FL 33542 / /' , <br />813-780-0020 FAX: 813-780-0021 :S ) 06 <br />DATE RECE IVED ' I <br /> <br />... <br />OWNER'S NAME e.. U ( "'-' <br />",,-\ . <br />JOB ADDR:Es'S ,~ ~ I <br /> <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />,..-; <br />/ 0 BLOCK' Oty-IvD <br />~ -~ -"I - PJCX.Io - ~J./1Ju- <br /> <br /> <br /> <br />PHONE <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY,TAX NOTICEl <br /> <br />WORK PROPSED: ~W CONSTRUCTION o ADDITION oALTERATION' o REPAIR o INSTALL <br /> o SIGN o MOVE 0 DEMOLISH <br />PROPOSED USE:~AMILY DWELLING oMULTI-FAMILY OJ OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK 11~ Si Y\.~ Ie...~. Ie s:~c1~~~.-. <br />BUILDING SIZE 11 ''if K 4// ~f SQUARE FOOTAGE 1% B <br />, ( <br /> <br />HEIGHT <br /> <br /><pI' <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 PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />...Q-13UILDING <br />~LECTRICAL <br />~LUMBING <br /> <br />~ECHANICAL <br />o GAS ~OFING <br /> <br />$ <br /> <br />PERMITS REQUESTED <br />I/Dt(251), ~ VALUATION OF TOTAL CONSTRUCTION <br />&. t:) D AMP SERVICE 0 Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />cd- -15D.<S0 <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION:$ 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 g..-NQ' <br /> <br /> <br />BUILDER <br /> <br />/1\ .---A---'" · <br />~~~ <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # Ck.. 03~ l.3c/ <br /> <br />**************************************************** <br /> <br />ELECTRICI~ <br />SIGNATURE <br /> <br />COMPANyJ'Y\ta-r~ ~ <br />STATE CERT OR REGIST # l2:C-l3w ( 38C3 <br /> <br />PLUMBER <br /> <br />~......................~~...~.....:::::::jt;~~~~~~ <br /> <br />1____ STATE CERT OR REGIST ~ )t.j&2S hoa-- <br /> <br />.~~~.:. ;;~':"~U'WU'~'~~~;~~~;~";;~-::::::Acp><{ ~-' <br />~. - STATE CERT OR REGIST ,e"A-~ 043'-178 <br />...:....................................~................. <br />COMPAN~ <br />STATE CERT OR REGIST #~~_ /~~~~ <br /> <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />OTHER <br /> <br />