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<br />CITY OF ZEPHYRHILLS PERM.lT A~~L.lCAT~U1'4 <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />S-/l"ld~' <br /> <br />, <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME4?, k\rv1. ..........~-.f-r~ ~ ke...]HONE '&>8 --1.g.:<-o'i?~~ <br />JOB ADDRESS ~ J... ~r-e-{ ~ 0 ~ <br />LEGAL DESCRIPTION, LOT IS) ~ BLOCK=SUBDIVISION~3V. <br />PARCEL ID # 3'-1-..:zC; ~I - -~CC>... '(OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPSED: ~ CONSTRUCTION 0 ADDITION o ALTERATION 0 REPAIR 0 INSTALL <br /> <br /> o SIGN o MOVE 0 DEMOLISH <br />PROPOSED USE:~FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />t"d enc... c:- <br /> <br />SQUARE FOOTAGE J d' 7C>~ HEIGHT S / <br />~ 1...J.JtJ1 ~ ~ ICi ~ .0;;' r <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLAN~ & (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 />~~'(Y\..dd ~ ~t J~ <br />PERMITS REQUESTED <br /> <br />~ILDING <br />'~ECTRICAL <br />~~BING <br />~ECHANICAL <br />o GAS ~ING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />~ 00 AMP SERVICE <br /> <br />J2('progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ 3~oO-OO <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 />I S PROJECT IN FLOOD ZONE AREA 0 YES ~ <br /> <br />.~~~~~~d~:;r"- "--,-- - - -- - ,- - , -1--~-~T~:-;-;"';0:'*':-f'~'lrl~~-:-D:~~0;,~ <br />~__.L.-...______,______~ <br /> <br />SIGNATU <br /> <br /> <br />COMPANY~~ ~+r--~~~~ <br />STATE CERT OR REGIST # ~&,--JO 035 J3t.f <br /> <br />BUILDER <br /> <br /> <br />COMPANyCa.s-r ~a.4.<!'_0~ 1~t:Ak ~ <br />STATE CERT OR REGIST # ~~ ~/~~I <br /> <br />~*************************************************** <br /> <br /> <br />PLUMBER ./ Jl /J _ COMPANY'" <br /> <br />SIGNATU~ ,A:::-- // STATE CERT OR REGIST <br /> <br /> <br />MECHANICAL ~....... .........:..........~~~;~~. <br /> <br /> <br /> <br />SIGNATU~~~ STATE CERT OR REGl! <br />*****:**** ***************************1::)****** <br />O~ ~ ~~~ <br /> <br /> <br />STATE CERT OR RF <br /> <br /> <br />flJ <br />b <br />Q <br /> <br />SIGNAT <br />