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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 eft St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />~'S NAME (V\Q.Ar.PAOt ~PSOA-... <br />JOB ADDRESS 2> <7 Sss ~)lJ.aot()LLJ'Dod Loop <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL 10 # I '3 ~d-.l.o ~a I . Ol40 tl'O'OoD ~ 0'/10 <br /> <br />PHONE g IJ,- )'t 0 oj ?7~ () <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />. [JSIGN <br /> <br />IORTAIN FROM PROPERTY TAX NOTICE\ <br /> <br />[J ADDITION <br />. [J MOVE <br /> <br />[JALTERATION <br />[J DEMOLISH <br /> <br />[JREPAIR <br /> <br />[J INS TALL <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[JCOMMERCIAL <br /> <br />OMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />o SWIMMING POOL <br /> <br />[J MOBILE HOME <br />[J OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF 1IORK ;;;5 ~ (;7 $A~ M. -AOY <br />BUILDING SIZE SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1 ) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />eJO <br />S./ 3'-/. <br /> <br />PERMITS REQUESTEO <br /> <br />[J BUILDING <br />[J ELECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />[J W.R.E.C. <br /> <br />[J, PLUMBING <br />o MECHANICAL <br />o GAS ,0 ROOFING <br /> <br />$ <br /> <br />[J SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[J OTHER <br /> <br />TYPE OF, CONSTRUCTION: [J BLOCK <br /> <br />[J FRAME <br /> <br />o STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />I S PROJECT IN FLOOD ZONE AREA[J YES 0 NO <br /> <br />I . ,', . C6N':MCTOR~~SECT:t61i" , ' <br />. IlUILDER 'C"''"''"'''''''~:~::ir P SrJ;fA- rh.s/ k. <br />SIGNATURE ~~y!.:~....... ....... ..::~:~.~~~:.~~.:~:::.:..:~~~.sR /, 1~ <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 />