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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />/7 1 BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />,bR(P,N ])Q4/u.V 813-780-0020 FAX: 813-780-0021 ~'r' 13 lOS <br />'. " . .? DATE RECEIVED - -- <br />~ 1/ -d-q~-'1,.)(j' . '-. j <br />o .~ L I PHONE CONTACT FOR PERMITTING SA-fYle ~ aunt.J <br /> <br />OWNER'S NAMJtRGH?.sf Tf1~s <br />JOB ADDRESS V1.?.. '-I 5-M q-, .2-1-1/115 <br /> <br />PHONE $13- ;1 $ ~/Y.58 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />.ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />~INSTALL <br /> <br />o SIGN <br />PROPOSED USE~SGL FAMILY DWELLING <br />[] COMMERCIAL <br /> <br />[] MOVE <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 Cffi15leud' ~(Jt:)/J1 iA ~4/e/( <br />1, heel / ~ SQUARE FOOTAGE I )/)0 <br /> <br />rt.dws e <br /> <br />BUILDING SIZE <br /> <br />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. <br />FORMS. <br /> <br />VALUATION OF <br /> <br />~"] C;, ~ '-> <br />"- <br />_6\.J <br />.~), <br />"7. ')- ";:;"~ <br />7 - <br />TOTAL CONSTRUCTION <br /> <br />tc7:;>~. <br />-? L}4^ C::, . <br />J <br />t2j,jLC , <br /> <br />o BUILDING <br /> <br />$ <br /> <br />~ <br /> <br />PERMITS REQUESTED <br /> <br />o ELECTRICAL <br />11 PLUMBING <br />[] MECHANICAL <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br /> AMP SERVICE [] Progress Energy 0 W,R.E.C, <br /> i~ ~MJ2- C\J-.JNfvt."- <br />$ VALUATION OF MECHANCIAL Y7-FfIO ~'OT <br />INSTALLATION <br />[] SPECIALTY [] flF-J{ \jl '\)~ <br />OTHER <br /> <br />TYPE OF CONSTRUCTION: _ BLOCK <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />[] OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES 0 NO <br /> <br /> <br />SIGNATURE <br /> <br />()fA)reI( <br />.~, <br /> <br />COMPANY <br /> <br />BUILDER <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 ~e tJ1Nfl~ <br />SIGNATURE Y _~. <br /> <br />COMPANY f) One. <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 />*******************************************************'k********* <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />