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<br />CITY OF ZEPHYRHILLS PEKMJ. '.1" .arr.LU..\..o.n..&. ~'"'~. <br />BUILDING DEPARTMENT 5335 8TH st, ZephyrhillS, FL 33542 <br />813-780-0020 FAX: 813-780-0021 01 G(I ~ <br />DATE RECEIVED r--L/--O\L- <br /> <br />~ <br />PHONE CONTACT FOR PERMITTING 5'~A C <br /> <br />OWNER' S NAME~ I -r g ~ /(,y i e L -r /{ /~ ,.I(! <br />JOB ADDRESS JY',;?~' ;r;c.},(/YlI4L //1// <br />LEGAL DESCRIPTION: LOT (S) :2. j~"' BLOCK <br /> <br />PHONE g/3. ;> 7? JS'9"L5 <br /> <br />SUBDIVIsIoNt[MeItAL..!}' A/~I Lv <br /> <br />(OBTAIN FROM PROPERTY,TAX NOTICE) <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />OSIGN <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />(2-:..[ . L.- 01' <br /> <br />OMULTI - FAMILY <br />o INDUSTRIAL <br /> <br />O. OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOMl <br />~THER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />. .- <br /> <br />DESCRIPTION OF WORK t/11/~t!'1J... ~ tf. Ct:/ # /bt/.#'!~/ A/ I Y' E.1... ~ ~-7~ J~+!'--- e toN.h JJ I' <br />BUILDING SIZE Itx.32...' SQUARE FOOTAGE J~Y. HEIGHT//,e-/'"" <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF <br /> <br /> <br />FORMS. <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY. FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS <br />PROPERTY SURVEY REQUIRED FOR ALL NEW <br /> <br />PERMITS REQUESTE <br /> <br />Ji/f ELECTRICAL \~ <br />~ PLUMBING /" <br />o MECHANICAL $ <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />progres s Energy j:r W. R. E . C . <br /> <br />-4> (g '-t ) SXJ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br />~RAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <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 />a~ <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />~ <br /> <br />COMPANY <br /> <br />ELECTRICIAN <br /> <br />6cV-IdA-. <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />,A <br /> <br />COMPANY <br /> <br />PLUMBER <br /> <br />tJrLbr~ <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 /> <br />.,:' ~/..4/ COMPANY <br />I " <br />STATE CERT OR REGIST # <br /> <br />OTHER <br /> <br />SIGNATURE <br />