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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH st, ZephyrhillS, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br />PHONE CONTACT FOR PERMITTING \~ ~ -~~~ <br /> <br />JOB ADDRESS <br /> <br />\'_ ~HY \. \...., C :::.-(:1)6 \ 1') -, N <br />SS ~ ~8-~'~ S~ \ <br /> <br />PHONE ~\~ \ ~~ r~~~ <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />/' PARCEL 10 * \1... 1.. \~. '::>.\. r;J::. ,0 .~-p - c \ ~ 9 <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROP~RTYTAX NOTICE) <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 COMMERC IAL <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 />--<,DESCRIPTION OF WORK \ '~>" "<: ~:0C' _e.. \ ~ \.\. s:. >,. , <br /> <br />BUILDING SIZE <br /> <br />RESIDENTIAL, ATTACH (21 PLOT PLANS & (21 SETS OF BUILDING PLANS & (II 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 /> <br />l// /o~ <br />PERMITS REQUESTED ~ <br />-.<.' $ . \ D C\ ~ . DD VALUATION OF TOTAL CONSTRUCTION <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />~BUILDING <br />o ELECTRICAL <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 />o MECHANICAL <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 AREAO YES 0 NO <br /> <br /> <br />BUILDER <br /> <br /> <br />COMPANY ~ (:) 'N'... Q...... C lA.,) 'C'o.. cu- .. <br />7 <br />STATE CERT OR REGIST # <br /> <br />/"SIGNATURE <br /> <br />********************************************************* <br /> <br />COMPANY <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************~************** <br /> <br />COMPANY <br /> <br />MECHANICAL <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />