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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-Q021 <br /> <br />PHONE CONTACT FOR <br /> <br />s: /7- f)~ <br />DATE RECEIVED ,- <br />PERMIT!'ING ~J~ ~R;' i joo <br /> <br />OWNER' S NAM~ ok;t~MPfS <br />JOB ADDRESS efJ <br /> <br />30 <br />01 ~(j) .00006 - O:!:J)O <br /> <br />PHONE <br /> <br />_0/5 1/5 /tJJ 0- <br />S1/ Ii,-r ods <br /> <br />LEGAL DESCRIPTION: 10T(S) <br /> <br />OJ' ~~- ;<.1 - <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OaLaIN FROM PROPERTY T~ NOTICE) <br /> <br />WORK PROPSED: []NEW CONSTRUCTION ~ADDITION []ALTERATION [] REPAIR [] INSTALL <br /> []SIGN []MOVE [] DEMOLISH <br />PROPOSED USE: []SGL FAMILY DWELLING []MULTI-FAMILY []# OF UN IT S [] MOBILE HOME <br /> [] COMMERCIAL [] INDUSTRIAL [] SWIMMING POOL [] OTHER <br /> <br />D RESTAURANT & <br />DESCRIPTION OF WORK ~ <br />BUILDING SIZE SQUARE FOOTAGE <br /> <br /> <br />t <br /> <br />f ILjr <br /> <br />1()0D <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) JFT ENERGY FORMS, <br />FORMS :If < <br /> <br /><Dl- -)~ f?:J.j)', <br /> <br />PERMITS REQUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] FLORIDA POWER <br /> <br />[] W,R,E.C. <br /> <br />o PLUMBING <br />[] MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES [] NO <br /> <br />L__..'_______.._________ <br /> <br />~QN'rMOD1Q.'~SlCI;'t!&N . J <br />.., e"',"',L~,.",'.''''~, .~,....~~,_~_ <br /> <br /> <br />COMPANY <br /> <br />BUILDER <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 # <br /> <br />********************************************************k********* <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER <br /> <br /> <br />..........................".,.....,.,..'.~.r::i:.:'........"'.. <br /> <br /> <br />\ COMPAN~ot tSfJiJ AlUMj~fY\ <br />L-- <br /> <br />STATE CERT OR REGIST # <br />