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<br />CITY OF ZEPHYRHILLS PERMIT APPLICAT'ION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br />PHONE CONTACT FOR PERMITTING ~ 5"c.., ZO/~ ,- [/ ~&8 <br /> <br />JOB ADDRESS <br /> <br />.....-- <br /> <br /> <br />V /l~ M~"- ~u!l.-ll t; ~ l '--D 4.1! <br />~ ~ <)"1 Ik lfv I LL-i .') n~ , v ~ <br /> <br /><; PHONE <br />7 - ll! t. L oS <br /> <br />OWNER'S NAME <br /> <br />~ '35'L(?, <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />o SIGN <br />PROPOSED USE:~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br />DALTERATION 0 REPAIR ~NSTALL <br />o DEMOLISH <br /> <br />PARCEL 10 # <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DMULTI - FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />) ~ t1;1..-L-A-n OU t.1?- c:::;' (? (l... I N It- L~, J2 5~ <br />, <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <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 FOFMS. <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 />~LUMBING <br />o MECHANICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <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 AREAD YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <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 />~/;? / // / COMPANY ~ GbI7Il ~ ~/~ f' /1212 i toA-r1 o-'U <br />~:(~I)VL-- STATE CERT OR REGIST # CA:') Lf {J ~J <br />/ <br />~ ****************************************************************** <br />MECHANIC~ COMPANY <br /> <br />PLUMBER <br /> <br />SIGNATURE <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 />