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<br />JOB ADDRESS <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICA'1'J.U1't Cvfi!d/ 4';).(-'C~-; <br />BUIWING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 c2t1 () > <br /> <br />(~,t11,M" PE:~TIETTREINCGEIV;;3 - <br />~ PHONE CONTACT FOR ~.~ ~ <br /> <br />fklt..LMIJ11fv1lcJJ~ f} , <br />3. B I Z-Z / Z-r/.f. IfV <br /> <br /> <br />PHONE <br /> <br />ff/~?gr- ~tf1 <br /> <br />OWNER'S NAME <br /> <br />SUBDIVISION <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL ID it /1-&10 - 2/- (JD ID- Ds;gD{')- 6 Z1tJ <br /> <br />{OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />OSIGN <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />O. 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 AP~ROVAL I~ _ <br /> <br />/ZI,IL (JIJIAdJ{1/vS I M C/A~ -/0 ~ (ff!;1) 6f'~/~~ I~ <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 ENERGjtORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ~~Z,)- :-------... <br /> <br /> <br /> <br />0~ <br /> <br /> <br /> <br />"'---~ <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />.fi BUILDING <br />o ELECTRICAL <br /> <br />$ Lf; 6{2. rJ <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy <br /> <br />o <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 />COMPANY <br /> <br />BUIIDER <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 it <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST it <br /> <br />***************************************************************** <br /> <br />OT.ER LDJ!il'5 UmI~ COMPANY UI'lkS C0^t'9MeJ. If"!- <br />SIGNATURE ~ STATE CERT' OR REGIST it DtLt o~ q <br />/ <br />