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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME fV/ a ru l,u J.. _ .:;; k .JS~~ ~ <br /> <br />PHONE 7/~ t;~ J8' <br /> <br />JOB ADDRESS ~?;>;-'2 >0 <br /> <br />Ntf),/'lh a v-€-. <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 />[JADDITION <br /> <br />DALTERATION <br /> <br />[] REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />[J MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: []SGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />[JMULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />0# OF UNITS <br />[] SWIMMING POOL <br /> <br />[] MOBILE HOME <br />[]OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK l..{ 7/'/ I 171 S' J,..P d <br />BUILDING SIZE 10 I k' ;< ~ f SQUARE FOOTAGE <br />r . <br /> <br />HEIGHT <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 ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED, <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] Progress Energy [] <br /> <br />W.R.E.C, <br /> <br /> <br />JI/O <br /> <br />o PLUMBING <br />[] MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] GAS <br /> <br />o ROOFING <br /> <br />[] SPECIALTY <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />[] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />COMPANY <br />~ f/?--.. ~ U M-- STATE CERT OR REGIST # <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 # <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 />