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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATIO~ <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME \<"0"( V W-I, {llvQ,~ <br />JOB ADDRESS 1~~5 \-+;-3k\G"'(~ Loo? <br />LEGAL DESCRIPTION: LOT (S) 30 <br /> <br />PHONE 715" - 1<.000 <br /> <br />L{lQ~~(k\\<", ~ L <br /> <br />BLOCK <br /> <br />SUBDIVISION OA\<.. Ru.rJ . <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />~ INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />% OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK ~ \ \00\ t...-'>co<::>J \It':\nc.i, ~~^(J{. <br /> <br />BUILDING SIZE <br /> <br />~OE> <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />~' <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 PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br /> PERMITS REQUESTED <br />~ BUILDING $ \~oO VALUATION OF TOTAL CONSTRUCTION <br />0 ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br />0 PLUMBING <br />o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION <br />o GAS o ROOFING o SPECIALTY 0 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 IS( NO <br /> <br />_~=-'--::!:"'''']=''1rrI~'1'''IT;;;P",'='''''-''''''''''-''--'-'--- ..---- -- -----..---- ---'~-~~""'"._.~.~=-~""""--='-~. <br />!!,af;"Jlf.N.:r~a;j!~lir: -1ljlL~ "i;':::::~'IJ;f:.jlfbflil~pr;;:]J;~];.ijviH~;jJJ_,,~;-I,t )i'till~~\f! ,I' H, -'I ~r-c, ',I -'p~ t I ~1~lH J,".~;J;t.!'t 'ti ;v;rn1~: Wiif:i-.iMflWI1!i l<, <br />~~~~~~~~]iliTiJj:i~__.._____.__.______ _______~J~I~ifur~t~,':i~if~~~ ''1!!f't4~'1' ,I ", ~ " <br /> <br />SIGNATURE <br /> <br />~-g Q <br />"y .:;(k tJ7V--:r <br /> <br />COMPANY +1~ne.IL- <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # <br /> <br />*****************************************************k************ <br /> <br />ELECTRICIAN <br /> <br />COMPANY <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 />