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<br />CITY OF ZEPHYRHILLS PERMIT APPLICAT~UN <br />BUILDING DEPARTMENT 5335 8TH st, ZephyrhillS, FL 33542 <br />813-780-0020 FAX: 813-780-0021 i I ) ~ 05 <br />DATE RECEIVED ~ - - <br /> <br />PHONE CONTACT FOR PERMITTING 81 ~- 'if:> 7-~46'!../ <br /> <br />JOB ADDRESS <br /> <br />ICls/J~ ~(jP6JZE, 12e16v1> <br /> <br />I <br />~5p 5"3 I/Ul/ 1A/I1f]) f?L <br /> <br />PHONE <br /> <br />q,.~1/~~ 7615 <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL ID #D2- Ue. Z--! 6Z,/A f50M06 (51),'2---0 <br /> <br />SUBDIVISION PYll.}-/tV-i!J <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br />o SIGN <br />PROPOSED USE: []SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />oALTERATION <br /> <br />o REPAIR <br /> <br />Jl(INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />oMULTI - FAMIL Y <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 />121 fL I W '~nvS / ML ~ I ~u~l+ 6f(l:lVlrv~ <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 ENERGYJORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ,r~ <br /> <br />{o'7, ~ <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />~b '-(3. fA <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 />[~.~_~=~~~i=:~,=_'~,_~.~:.~=~=,~-~'~~~:~:. _~_~~ _ __ __, -- __ _ _ " __ __ _ - :~~~:~~:__~_~~:,~~~_-~~'_:: _-=~~--'~~~~il::~~: I; <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <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 (p1l'K/5 l~~J /NL <br />SIGNATURE /Y~ 1 ~. <br /> <br />COMPANY Uf/l;.€l,S )1rn't ~:wrd J tv!- <br />STATE CERT OR REGIST # .G/ZL6S-116 f <br />