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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 STH st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-7S0-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />j'-A () IT 1/ f) ;) IN !3 /Ill 1/ c <br />'3 g 41 :l9. (! iP- J-{?- !?H?,7 <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <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 />~ERCIAL <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 />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />/ .-7:4 //I' ,y ,/lAZ>/lJ I'/DA ~ Y./.?"~U-r <br /><; -/V??P tJ/,?r/?"4J.5e:'~# -7;?57~ ~H$/~ <br />" .,. <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />o BUILDING <br />- <br />!:9-"'ELECTRI CAL <br /> <br />o PLUMBING <br /> <br />o MECHANICAL <br /> <br />PERMITS REQUESTED <br />$ ~ 5 t:e/ I e1P VALUATION OF TOTAL CONSTRUCTION <br />Llx//r/tGt AMP SERVI~E 0 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 />_~~;;;"':;""'"",--:r"'1~-----------------------'- ---T';-;-m:nv-T;(PF'~--I".p't;~;;r"ij'""'i':!ffiii!"~' . . <br />'c~" Ii"' IDil ,He: ~,::"Ji':'~i,.;~ "~-,:,':,:! ~ 1:;, \ F!c; ~~f![,~f.;i:;'~''i, ~~~m!i:lliltljf,',' , I " <br />I1dJh_il~~L________________________._Jru:~_Jd:;I~:\,~mt,~.if",n5~,~ ~, ,,~I., " , <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />#~?~4'~# <br /> <br />COMPANY /I K /,A.)..ft /..?~C ?/Ve' C!; <br />STATE CERT OR REGIST # 5e tJt:>OtJ ~ 9 t/ <br /> <br />ELECTRICIAN <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 />