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<br />CITY OF ZEPHYRHILLS ~.I!i}(M.L..L. fiCr.LI.L'-'.n.........,... <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 1-j -I c:: -0 5" <br />DATE RECEIVED -' <br /> <br />Gc!&ut jJ"U~?-- <br />OWNER' S NAM~ t-\ '( (' rf \> A.~ () I I ~ <br />JOB ADDRESS . '~J 91'S ~~9 ~\v~, -Z~~~u}..~"Q" ,r-L ~~Sy\ <br /> <br />PHONE GONTACT FOR PERMITTING <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />PARCEL I~ # O~. ;;:)(...,- d \ - DO'O - OIoLtro, OOJ I <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br />PROPOSED USE: OSGL FAMILY DWELLING <br />~OMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI - FAMILY <br />o INDUSTRIAL <br /> <br />0. OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOMl <br />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK ~e 'fC XJ f ~Q ~ <br /> <br />BUILDING SIZE <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 1 ;:.JtS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. ~ ~ <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. t~4~ <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br /> PERMITS REQUESTED <br />o BUILDING $ ;)~ foC? VALUATION OF TOTAL CONSTRUCTION <br /> , <br />0 ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br />0 PLUMBING <br />o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION <br />o GAS o ROOFING o SPECIALTY 0 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 />COMPANY <br /> <br />BUIWER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />COMPANY 5s:-cflt'13I~clclv.e-"""" \2u0-h~ :r~. <br />STATE CERT OR REGIST #CcC OS",} CJ s fJ <br /> <br />OTHER ~(')o-f;'~ <br />SIGNATURE .2....)....-.-..tr---- ~.~0-r" ~~ <br />