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<br />, . <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 eTH St, Zaphyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />1-;z,o -oS <br /> <br />OWNER'S NAME 6..,.,lkrJ. f,': f J Met g~Lr;J <br />, . 11; ,---- <br />JOB ADDRESS . s.I <br /> <br />LEGAL DESCRIPTION: LOT (S) (; f7'-7 BLOCK <br /> <br />H<.I ;-r ~ <br /> <br />PHONE <br /> <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />$7 <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # -2. b )../ - 00 t:l- 0,5-76 c -- () 6~ 0 <br />WORK PROPSED: ~W CONSTRUCTION o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br />PROPOSED USE: ~ FAMILY DWELLING <br />o COMMERCIAL <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 HOME <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK tJ<::.o:AJ #..J t.O 2/~t.. ;:-:;;n"'1'0 _CI0e/~/lJ <br />BUILDING SIZE ,.~)< $10 SQUARE FOOTAGE /'1 7~1 HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY'FORMS:1 <br />F, .0, RMS. , /-~, / <br />~~ / <br />~ <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF <br /> <br />/ <br />Progress Energy 0 W. R:~. <br />/// '> <br />L~ 1_111 g ; <br />MECHANCIAL INSTALLA&,' <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE 0 <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 AREAD YES 0 NO <br /> <br /> <br />BUILDER <br />SIGNATURE (rJ ~ ~'.cl <br /> <br /> <br />STATE CERT OR REGIST # <br /> <br />*.~1t~d,~aI~.. <br /> <br />.' <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />(~-- ~ <br /> <br />STATE CERT OR REGIST # <br /> <br />PLUMBER <br /> <br />...........................................................~..~ D~ <br /> <br /> <br />COMPANY <s;.rJ~.. ~t1~ ~ <br />uJ o.y.-- 12.~ STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />***'r************************************************************* . <br />/.I;j ? COMPANY, ..$ "'......A>' 7 .; . tJ f-.. <br />)':j ~ ht"7"'7~ STATE CERT OR REGIST # I( fJ,. 06 ! '( <{ ~ ! <br /> <br />MECHANICAL <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />