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<br />CITY OF z~~~~~n~~~u ~----- <br />BUILDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />JOB ADDRESS <br /> <br />John <br />S4'a Cl <br /> <br />\- 'Jenr\ L -Cer <br />I 'l-r:n S +- <br /> <br />DATE RECEIVED cI-J~ -Or <br />PHONE GONTACT FOR PERMITrG 6~1?7 4/% <br />Pel me {' PH~El, 78-?, -q 2,1 b - <br />'2.Q{?h.y r h It I s <br />~ BLOCK Lj Q <br />- 06 J 0 (JL{ ';)00 -00, <br /> <br />OWNER'S NAME <br /> <br />SUBDIVISION <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 10 # 11- d V -;1 t <br /> <br />{OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOl-' <br />~OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT AP?ROVAL <br />DESCRIPTION OF WORK P 00 \ E nc lo..s lit ( '(3 <br />r;od .e:J <br /> <br />BUILDING SIZE <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 />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />,~ BUILDING <br /> <br />$ & q 00, dO <br /> <br />PERMITS REQUESTED <br /> <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />$ <br /> <br />VALUATION OF <br /> <br />Progress Energy 0 ~,;k_E .c. .,~') <br /> <br />j r/ I~!J/ / <br /> <br />MECHANCIAL INSTALLA~ <br /> <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />AMP SERVICE 0 <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />-- <br />,~) '> <br /> <br />/'~ <br />o STEEL 0 OTH~: tA!t,>>-; ~\I <br /> <br />IS PROJECT IN FLO~~Ejf'f"ES Co NO <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />BUILDER <br />SIGNATURE~ ~ .. <br /> <br />COMPANJ<~t+-hI1~lPS ~orS+' Ji/(l <br />STATE CERT OR REGIST # c: rz..c...Ol/Q... LjCj R' <br /> <br />*****************************************A(***7*******~***** '~ <br /> <br />/l <br /> <br />COMPANY- """-- <br /> <br />-,.,.- <br /> <br />-----:- <br /> <br />ELECTRICIAN <br /> <br />~.-... <br /> <br />SIGNATURE <br /> <br />~. ~ _ r <br />STATE Cr..u v[\. REGIST f - <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 />