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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 ~~7~S- <br />DATE: RECE IVED / / <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME ~ f? -r: 1/:_ ~(\ ~ . PHONE. 'S1J:.lQ-LXi'.;J.<;; <br />3 'lIte 1 ADDRESS ~ /) g ~-;-,~ 1. Cu--r e-/ -::j:I~-, , t <br /> <br />, <br /> <br />LEGAL DESCRIPTION: LOT(S) o4Q;e:, BLOCK~ SUBDIVISION 0 {aD <br />PARCEL 10 # '3+-~5-.;t;lJ -Of 3D- ~ - OC/-f?,g (OBTAIN FROM PROPERTY TAX NOTICEl <br />WORK PROPSED: ~NSTRUCTION 0 ADDITION DALTERATION 0 REPAIR 0 INSTALL <br /> <br />o SIGN <br />PROPOSED USE:~;~ILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <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 />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK h~.s. r n~ le-,~'t t'1 A-Q~ {-~ L' II <br />BUILDING SIZE fc//;( (0 {l'l tr SQUARE FOOTAGE S/o/ '~r4-L HEIGHT g f <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (l) SET ENERGY FORMS. <br />FORMS. <br /> <br />PERMITS REQUESTED <br /> <br />l:\ .Lj3(, ? <br /> <br />O'BUILDING <br />~ECTRICAL <br />~~MBING <br />~CHANICAL <br />o GAS ~FING <br /> <br />$ / SeXXSU c>-~ <br />cXc0CJ <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />~~ogress Energy [] <br /> <br />W.R.E.C. <br /> <br />$16 Wp 0 <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION:~CK <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 []-tro <br /> <br /> <br />SIGNATURE <br /> <br />. J ... COMPAN /' L- <br /> <br />~ ~C'iY STATE CERT OR REGIST * (lJ.IiY~O~{3'-1 <br />d <br /> <br />**********************************::::::~:;~~**~~:~*~**~~{,L~ <br /> <br />STATE CERT OR REGIST # r.;;:-rJ<... 60 [(/5'9/ <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br /> <br /> <br /> <br />_ ",/ - COMPANY~l.s. l:J(v{(~-S !u-.-J>,"1;. <br />~ ,''A'y:'4A..AC# STATE CERT OR REGIST # ~ Fe -:<.5 to (],;L <br />~ (/ <br />MECHANICAL *;*~******************************~~~;~~~**~.~**::- ;:*~ rD ~ ~ <br /> <br />SIGNATURE D" cU STATE CERT OR REGIST 11 c.,~ 0 L/ 347 J> <br />(j <br />***************************************************************** <br /> <br />OTHER ~ _ COMPAN~~""'_- <br /> <br />SIGNATURE ~ ------------'--_~ STATE CERT OR REGIST # ~ /3~S'"7 <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />