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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aTH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br /> <br />:; /~~!05 <br />( ( <br /> <br />PHONE CONTACT <br />-r!f<f;' ;Z~.A-1,v. ~//I ~c)h--.:'J,€_ <br />OWNER'S NAME ;;;t...EC:-(~errd:'-e:-~ G,j ~5'~TC,,-1.'(c;,: <br />JOB ADDRESS S\~ J.S bA-z... '-- /!L) <br /> <br />FOR PERMITTING <br /> <br />c.,. -(k,!:.~ -.Snr- G::.J17 ' <br />T7VC PHONE <-e../ (8;/ 3., 9 ~~ . 7'1 cf} <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INS'fALL <br /> <br />Os I GN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-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 />r;; Ie A LA /!/<-1 S('-S'T-P ttl, <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RES IDEN'I'IAL: ATTACH (2) PLO'l' PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IE' SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />PERMITS REQUESTED <br /> <br />{Lf)'3\ <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />. Or <br />12---6 D <br />1 <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAS <br /> <br />o ROOFING <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 /> <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 />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />S I GNATURt~ <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER <br /> <br />*A****************************************~}******~****~*****61~* ,P//'~ <br />~ CLeCfr-oIv' /L~ec\- " ( <br />COMPANY ~ yS'I-f.A.-1S j ~/c. <br /> <br />O~ ~t _.. STATE CERT OR REGIST # E f' DC t-c) 9'/0 <br /> <br />SIGNATURE <br />