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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 />4- j/- oL)- <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME Lt roUY"Ic:uhCY'\ loc..o...-:k.-. I f'\ L. PHONE <br />JOB ADDRESS 506~ l~ S-We.LY ZQ.pV\L.f( hll L). P- 2:>~sY 'L,.. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL Ii:! # -1 \.)..~. ').. l. aa\ D. a.oiOO' O.;L.l a <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />~ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />~ 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 c...r"ll,t'''\~ fY\rll~ pt1Y')P I ~fY\ C.L ~ ~t /1, r\ \'~("C'v"'1tV c+ ~ fV"\ru^ <br />b(E'~ pCU"'\e-\ . <br />BUILDING SIZE SQUARE FOOTAGE 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 />o BUILDING <br />~ ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />// () -1 :; <br />PERMITS REQUESTED ;/ /ff U ~. <br /> <br />VALUATION OF TOTAL CONSTRUCT~ <br /> <br />l50 <br /> <br />AMP SERVICE <br /> <br />~ Progress Energy 0 <br /> <br />W.R.E.C. <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 />COMPANyR(?e~p 5 pr J-n' (Ci U(\{ <br />\~1 <br /> <br />ELECTRICIAN <br />SIGNATURE l~~~ ~ ~ <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 <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />