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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPAR'l'MENT 5335 8ft! St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />OWNER'S NAME <br /> <br />JOM <br />.3 tjtJ3 <br /> <br />H 09 Q f) <br />mfL/(~jJJit IJr/Ve <br />/I.//; <br />tJ- '/ - ,).~ -r),/- 00 l.j() -0ct:k)J - / f/ & () <br /> <br />DATE RECEIVED <br />PASCO PE Mlr 5E:RV'I( <br />PHONE CONTACT FOR PERMITTING 1-'iSccG,-gAt(-7Sc::pl <br /> <br />PASCO PERMIT SERVICE <br />, PHONE 1-AAfi-R?4-7R~4 <br />To!! Free <br /> <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />SUBDIVISION:rk fmra/tl Po/Ilk If// <br />J:Nd/' f PIJ-oL <br />lORTAIN FROM PROPERTY TAX NOTICE) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: '~NEW CONSTRUCTION <br />OSIGN <br /> <br />o ADDITION <br />o MOVE <br /> <br />OALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE:OSGL FAMILY DWELLING <br />o COMMERCIAL <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 />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />.sC-'LUA room room a.drt'I-/(J~ + <br />SQUARE FOOTAGE 5(YI f <br /> <br />DESCRIP'l'ION OF WORK <br /> <br />BUILDING SIZE <br /> <br />/ <br />3(; X Icj <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 />?' BUILDING <br />o ELECTRICAL <br /> <br />$ <br /> <br />les{X).fYJ <br /> <br />PERMITS REQUESTED <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br />r~7 ,)0 fjwG. <br />~)~_ ~':. ~C <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />W..R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAS <br /> <br />o ROOFING 0 SPECIALTY <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 AREAO YES 0 NO <br /> <br />BUILDER <br />SIGNATURE ~Jt1c'\... jut[ <br /> <br />..... ..--". .,'.' _, _,' __d__', <br />C~TQR.f;Sii:CTI()N <br />.'.; -' .'- ;.' ..... . -;.. -' - ,-' .;;: ?:-,<.... :~,'.- '. :".J~'~ ""':;"',,,,:',.".:;~.: . _'.. _." -;. .. .., . .. ," ..:., n' .l <br /> <br />COMPANY- 0C//) s4)? .4tu./J(. n c <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 />PLtlHBER <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 />