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<br />CITY OF ZEPHYRHILLS .l:'J!jKM~'~' firr.LI.....'-'.n.~.......,... <br />BUILDING DEPARTMENT 5335 STH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:S13-7S0-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME lJeff ~ fU~Gd Ixdw/v <br />JOB ADDRESS .5""122 ;2;J::/ :sf. <br /> <br />PHONE (?1L~ )7;1;2 - s-oi'1 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPF.RTY.TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />)(REPAIR <br /> <br />o INSTALL <br /> <br />OSIGN <br />PROPOSED USEyEfSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNrrs <br />o SWIMMING POOL <br /> <br />o MOBILE HOMl <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL <br /> <br />te - ~p <br /> <br />BUILDING SIZE <br /> <br />30 ~ (.,0 I- '7- <br /> <br />SQUARE FOOTAGE <br /> <br />?&IJD <br />~ <br /> <br />HEIGHT <br /> <br />?I <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 />o PLUMBING <br />o MECHANICAL <br /> <br />AMP SERVICE <br /> <br />o 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 />SIGNATURE <br /> <br />60 cJ~ <br /> <br />COMPANY <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <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 />