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<br />\'t~1 <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 ~ :)/ I()JDr <br />DATE RECEIVED~ <br /> <br />PHONE CONTACT FOR PERMITTING ~n.l\ \.Jl"~'f <br /> <br />OWNER'S NAME <br /> <br />[u,()C&y ~ft/S, LM6 <br />7~d-.l3~A) . ST- <br />103 <br /> <br />PHONE 8/3 -qi ~ - ;J5CA <br /> <br />JOB ADDRESS <br /> <br />PARCEL ID # 2:D-dQ- d \ <br /> <br />BLOCK ~ <br /> <br />rp,. t(frj <br /> <br />SUBDIVISION Ou..l-f-vitvJ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: rilSGL FAMILY DWELLING <br />o COMMERCIAL <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 />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK lSio S& 11,.JCZt?U 1r rvJ/ Jab ~ <br />BUILDING SIZE ~ SQUARE FO TAGE ~3/4 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 />~LDING <br />~CTRICAL <br />~MBING <br />~HANICAL <br />o GAS ~OFING <br /> <br />PERMITS REQUESTED <br />$ tW \ SlCS VALUATION OF TOTAL CONSTRUCTION ). <br />dill AMP SERVICE 0 Progress Energy ~ lj. <br /> <br />W.R.E.C. <br /> <br />$~ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: if BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES ~ <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />s <br />CAe o1~&9j <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />-...-'.' <br />****************************************************************** <br /> <br />ELECTRICIAN 4x. <br />SIGNATURE <br /> <br />lOdl/~~ <br />. tJ <br /> <br />COMPANY &I ty){]J1.. 'i;;Jt(--- <br />STATE CERT OR REGIST # 00/3/3 .tf <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />~ <br /> <br />;J/J2wJ(~ <br /> <br />(/ <br /> <br />COMPANY ~.-J- <br />STATE CERT OR REGIST # CFc..,oL/J- 99 f <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ::iF * * * * * ~ * * * * * * * * * *..* * <br /> <br />~ 1 COMPANY. Q 3 '-IJ/hAl s{J~ <br />. l,tU ~L~d; STATE CERT OR REGIST # C/tCOS/J ~/ 0 <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />.... 7;........:........ ..... "'::~:::;'c' '&~'k-;"~ <br /> <br />71lfJ;L j{ Cf:1LL~ STATE CERT OR REGIST # lie/I i:,- () /3 <br /> <br />OTHER <br />