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<br />CITY OF ZEPHYRHILLS PERMIT APPL1CATION
<br />BUILDING DEPARTMENT 5335 8ra St, Zephyrhills, FL 33542
<br />813-780-0020 FAX: 813-780-0021
<br />
<br />DATE RECEIVED
<br />
<br />^ 1\, [L.- PHONE CONTACT FOR PEIlMITTING ?13 7':3 0. <15 ao
<br />1m 1#(' L ut-r . l2,tt N !:lVi-yW~.l?
<br />OWNER'S NAM~ f' l{(jY2Ji c VL L~ . ,PHO~E '61~ 133 75/Xl
<br />JOB ADDRESS .31 c=J;;;',i) 'VaQOQMGJ\Y1ccfGAI\~,2-f1,II~~ :335tf~
<br />~O~
<br />LEGAL DESCRIPTION: LOT(S) ~ ~
<br />
<br />BLOCK
<br />
<br />SUBDIVISION
<br />
<br />PARCEL ID #
<br />WORK PROPSED: 0 NEW CONSTRUCTION
<br />DSIGN
<br />
<br />o ADDITION
<br />o MOVE
<br />
<br />(OBTAIN FROM PROPERTY,TAX NOTICE)
<br />DALTERATION 0 REPAIR ~STALL
<br />
<br />o DEMOLISH
<br />
<br />PROPOSED USE: DSGL FAMILY DWELLING
<br />o COMMERCIAL
<br />
<br />DMULTI-FAMILY
<br />o INDUSTRIAL
<br />
<br />0# OF UNITS
<br />o SWIMMING POOL
<br />
<br />~ILE HOME
<br />o OTHER
<br />
<br />DESCRIPTION OF WORK
<br />
<br />c:J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL
<br />
<br />~~^~.L-- l~crt-G \ l s
<br />
<br />BUILDING SIZE
<br />
<br />SQUARE FOOTAGE
<br />
<br />HEIGHT
<br />
<br />PERMITS REQUESTED
<br />
<br />
<br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET
<br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
<br />IF SIGN PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED.
<br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION.
<br />
<br />o BUILDING
<br />
<br />$
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />o ELECTRICAL
<br />~UMBING
<br />o MECHANICAL
<br />
<br />AMP SERVICE
<br />
<br />o Progress Energy 0
<br />
<br />W.R.E.C.
<br />
<br />o GAS
<br />
<br />o ROOFING
<br />
<br />o SPECIALTY
<br />
<br />VALUATION OF MECHANCIAL INSTALLATION
<br />o OTHER
<br />
<br />$
<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 />
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<br />It, 11'1"'~" ti , I' '1 . : : I .-.... Il;,1if:ll,lj-.,_.~~....l r't>H;i?'1f~r;t1.&.e~'!
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<br />tI;......w...:..<:.....u__..........,..-li__.. .li...>.ll_...._~.l._.....~._.__..,~.....,:.._"_....._.............~..........~.l. _ _ ____ _ _____ __ _ _ __ ___ ___'N~~_...l.~..J;;...'-~~..~
<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 />
<br />PLUMBER c' COMPAN~ i!-.,.lJ~ Ylt~.
<br />SIGNATUR~D~ aM~ STATE CERT OR REGIST # m.!4;J..5cS{)].-
<br />
<br />******************************************************************
<br />
<br />MECHANICAL
<br />
<br />COMPANY
<br />
<br />STATE CERT OR REGIST #
<br />
<br />SIGNATURE
<br />
<br />*****************************************************************
<br />
<br />OTHER
<br />
<br />COMPANY
<br />
<br />SIGNATURE
<br />
<br />STATE CERT OR REGIST #
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