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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 .~ /,- \_o~ <br />DATE RECEIVED ~ <br /> <br />PHONE CONTACT FOR PERMITTING 5 2? cc-\ I.ob'"~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PHONE/8d-SL{I~ <br />2-<-~ ~ PI <br />SUBDIVISION (}Y;'f1W~ <br /> <br />JOB ADDRESS <br /> <br />~\ -\v- <br />b}l~ <br /> <br />D~ 'cS <br />~SSWOO(~ <br /> <br />C\ rc\Q <br /> <br />OWNER'S NAME <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY.TAX NOTICEl <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <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 />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />~~ <br /> <br />~~ toJJ <br /> <br />GAr <br /> <br />a-.~ <br /> <br />''-'0' (a ~1 <br /> <br />HEIGHT <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <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 />o BUILDING $ 'd \60 .OU 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 AREAD YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <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 ~f\~ <br />SIGNATURE------2 h r'~ ~ ~L.< 4. ~ <br /> <br />COMPANY Scc\\ .~'0~, X-""- ~f2-\,",) <br />STATE CERT OR REGIST # C C. C 0<;;' '7 ~ '1_ <br />