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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 RECE IVED <br /> <br />J;A It;; <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME Bel-Al'rt. " <br />JOB ADDRESS '8,/ I AJahasf~Y DI" LDt .120 <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />(OBTAIN FROM PROPERTY,TAX NOTICEl <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />~BILE HOME <br />o OTHER <br /> <br />OSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />c:J RESTA~~& HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK ~ ~ /.Jl-t --<-T <br />BUILDING SIZE 1'-/ X 3 (P 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 />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <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 />SIGNATURE <br /> <br />COMPANY <br />h Cy~ ~ L .;:/ STATE CERT OR REGIST # <br />........~...*Jf.'................................................... <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br />SIGNATURE f.-.,/.,,__ B~~ <br /> <br />COMPANY Crand aJ ) <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY 8 Ll-t-t~t'jd <br /> <br />SIGNATURE ~,...--. B~~L~ <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />* ** * * * * * * * * ** * * * * * * * ** ** * ** ** * ** * ** ** * ** ***g* h* ** * ** ** * * * * * * * **.* <br /> <br />COMPANY . a y5 <br /> <br />SIGNATURE <br /> <br />b1/'-}-~ (?~~ <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />