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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 RECEIVED <br /> <br />~-II-05- <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME ~\,:rbNS. -KP i!(1Q..,Dy PHONE <br />JOB ADDRESS . %3'0 d.-O~ SHu t-' Zerhl\(~\\h--, k ~~SY:L...- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />l4- d-ln- d.-\- OOlO-- O'd,4CD.- DO$l) <br /> <br />{OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: o NEW CONSTRUCTION o ADDITION mALTERATION o REPAIR o INSTALL <br /> DSIGN o MOVE 0 DEMOLISH <br />PROPOSED USE:~SGL FAMILY DWELLING DMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK Upy'r.t\C1 N'..-u'l~ -to \StJ~c... . L,~tul\ el.l4'<.l.rkvrV\L.~ mAP \ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />.. <br />" <br /> <br />/.-----~- <br />/~ '"', <br />\, <br /> <br />-~ <br /> <br />PERMITS REQUESTED <br /> <br />(/ l J./D1D /-// <br />~~-- <br /> <br />I<S;D <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />~ Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o BUILDING <br />~ ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />AMP SERVICE <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 />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />COMPANyt<~ese... E \~:\I\,<...o_J, 1 I(\<.... <br />STATE CERT OR REGIST # \~~~ <br /> <br />ELECTRICIAN <br />SIGNATURE \C~/y,-,l>>-~ ~ (2 <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 />