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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8ft St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IWD <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br /> <br />1- ,Jeu.bR-i{ <br /> <br />PHONE d 11/7" 9 77'-1666 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL ID # '14 -J. ~ ~o-.I. CO I D . Od-~W . OD[)D <br /> <br />SUBDIVISIO <br />(ORTAIN FROM PROPERTY TAX NOTICE} <br /> <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />, [JSIGN <br /> <br />[J ADDITION <br />, [J MOVE <br /> <br />[JALTERAT ION <br />[J DEMOLISH <br /> <br />[JREPAIR <br /> <br />[J INSTALL <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[JCOMMERCIAL <br /> <br />DMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />[J OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />o REST~T . HEALTH DEP~NT APPROVAL <br />c::3'l S- c:> .shu4J ;u '"1\ Ord..- <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 FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />[J BUILDING <br />D ELECTRICAL <br /> <br />$ <br /> <br />~ oJ <br />S,L/-/3. ;) <br /> <br />PERMI'rSuBEQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />D W.R.E.C. <br /> <br />0, PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAS 0 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 AREAD YES D NO <br /> <br />BUILDER <br /> <br /> <br />COtm\ACTOR:~1SlCCT:r~ <br />!.;~ ,.'~..'::. ;..: T.~ . -,; ::(~;_~ .....:.:.\..I.ll.:-._,.:.~ ,''';.' ~ '::"'0{. "_ . :'_,~ ; :.' ," ..',. "." .,1',:.0,. >, <br /> <br /> <br />COMPANY <br />STATE CERT OR REGIST ~ Lee..- f) ~g / ,3 ( <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 />MECHANICAL <br /> <br />****************************************************************** <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 />