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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St I Zephyrhills I FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />i>)3ks- <br /> <br />/ <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br /> <br />OWNER'S NAM{!/l61 K' j F' <; 0-..5:,. r .&/1/4!p,Eht:;:.,F <br />JOB ADDRESS \.~'1,-S-:-S- 9-z::t1: 5 /.. 2*/ ~Y.(/fzLL (' <br /> <br />PHONE -0? - /!?7- 3603 <br /> <br />33 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: [)NEW CONSTRUCTION <br /> <br />[)ADDITION <br /> <br />[)ALTERATION <br /> <br />[) REPAIR <br /> <br />[) INSTALL <br /> <br />[) SIGN <br /> <br />[)MOVE <br /> <br />[) DEMOLISH <br /> <br />PROPOSED USE: [) SGL FAMILY DWELLING <br />[)COMMERCIAL <br /> <br />[)MULTI-FAMILY <br />[) INDUSTRIAL <br /> <br />[)# OF UNITS <br />[) SWIMMING POOL <br /> <br />[) MOBILE HOME <br />[) OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK I( E ~ pfC7D';:: 41L-rFf...l. ,?!c;o,;= <br />BUILDING SIZE ..x r;< ~ 1/ -I- SQUARE FOOTAGE g-O I <br /> <br />HEIGHT / 5/4.< } <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. <br />FORBS. <br /> <br />5L:5~ ,~U)l:. <br /> <br />PERMITS REQUESTED <br /> <br />[) BUILDING <br /> <br />$ 70CJ-~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[) ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[) Progress Energy CI <br /> <br />W.R.E.C. <br /> <br />[) PLUMBING <br /> <br />[) BECHANICAL $ <br />[) GAS ~OOFING [) SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[) OTHER <br /> <br />TYPE OF CONSTRUCTION: [) BLOCK <br /> <br />[) FRAME <br /> <br />[) STEEL <br /> <br />[) OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[) YES [) NO <br /> <br /> <br />SIGNATURE <br /> <br />~ <br /> <br />#- <br /> <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # <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 <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />