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<br />CITY OF ZEPHYRHILLS PE1{M.1..J: IU'I.' J,.I.L\...ru. ...,-,... <br />BUILDING DEPARTMENT 5335 8TH st, ZephyrhillS, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />'1~f'-CJ~ <br /> <br />pHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME ~ Q. ("Y"Je 5 1t3a.efYJdZa- /?;O."J..}:5e,e <br />JOB ADDRESS $ If '/0 q)u/2,na..L'/7.e nrzn/e <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />= <br /> <br />(OBTAIN FROM PROPERTY TAX 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 />PARCEL 10 # <br /> <br />OSIGN <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <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 HOM] <br />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <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 /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />~ <br /> <br />DESCRIPTION OF WORK <br /> <br />? h.>....do 1.v~ -tv <br /> <br />\ <br />[,..Ja (](:A, ( <br /> <br />BUILDING SIZE <br /> <br />& (1) SET ENERGY FORMS. <br />FWMS, <br />+r ~L $cD <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <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 />COMPANY <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />PLUMBER ..~ COMPAN':k12~~lZ- ?h-""b, <br /> <br />SIGNATURE;\ HW ,'H HWW:2L.:H. .:::::. :::: '::H:::::': *** *** H" r;:J : <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 />