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<br />CITY OF ZEPHYRHILLS PE.KM.L..1" .RJ:"J:".LI.L'-'.n.&.~""'''' <br />BUILDING DEPARTMENT 5335 STH st, Zephyrhills, FL 33542 <br />813-780-0020 FAX:S13-7S0-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME < '0 (\ ~ '\:" L~\L:f'':>. PHONE ~'b d ~ ~q'l:\ <br />JOB ADDRESS ~~~\O ~","<.- D\ ~f~ ~l..'~? <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPF.RTY TAX NOTTCE) <br /> <br />PARCEL ID # <br /> <br />\J.-- <br /> <br />0-6 a\ ()O~6 CO'-\D O\\a <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL 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 HOM] <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT AP?ROVAL <br />~~ <br />\) <br /> <br />'- <br /> <br />'J S- ~\ <br /> <br /><..~ <br /> <br />BUILDING SIZE <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 FORHS. <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 /> PERMITS REQUESTED <br />o BUILDING $ L\ ~ 'E:>Q .00 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 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 />****************************************************************** <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 />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />COMPANY "'Scf>\\"b\c..~ \: ~~ nw \ l~ l.:'"'C <br />STATE CERT OR REGIST #cccoSil'8l <br /> <br />OTHER ~O(= \ "S <br />SIGNATURE c ~n-- <L~~~ . <br />