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<br />OWNER'S NAME <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FIJ 33542 ~ <br />813-780-0020 FAX: 813-780-0021 5 IO/~~ <br />DATE RECEIVED -, 4lL..l... <br /> <br />PHONE CONTACT FOR PERMITTING JOh n U \} e { V <br />~'3~q/~~~-~ <br />PHONE f~ (tf/~4:~jJ3 <br /> <br />JOB ADDRESS <br /> <br />?U:J..L( <br /> <br />W..l-f-vitvJ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 10 # ~d5-al- <br /> <br />SUBDIVISION <br /> <br />/OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~ NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />[J REPAIR <br /> <br />o INSTALL <br /> <br />OSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: rilSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI - FAMIL Y <br />o INDUSTRIAL <br /> <br />0# OF UNI'rS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK lS/.. II S& <br />BUILDING SIZE ln~,>(.c...tlJ <br /> <br />UCZ'1U/~ ~d< ~ <br /> <br />SQUARE FO T:GE c9Sl.{ 'f <br /> <br />HEIGHT <br /> <br />~tt <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 />$ <br /> <br />/3ot I 900 <br /> <br />oJx) AMP <br /> <br />PERMITS REQUESTED <br /> <br />~ILDING <br /> <br />t:vEi~CTRI CAL <br /> <br />~UMBING <br /> <br />~ECHANICAL $ ~(:) VALUATION OF MECHANCIAL INSTALLATION <br /> <br /> <br />o GAS ~FING 0 SPECIALTY 0 OTHER <br /> <br /> <br />TYPE OF CONSTRUCTION: ~BLOCK 0 FRAME <br /> <br /> <br />FINISHED FLOOR ELEVATIONS JL/.G . DO <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />SERVICE <br /> <br />o <br /> <br />Progress Energy ~ <br /> <br />W.R.E.C. <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />)( NO <br /> <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />:5 <br />CI3C 01&&9~ <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />~ <br /> <br />JJu~ <br /> <br />COMPANY Edty)~~ <br />STATE CERT OR REGIST # 00/3/3 'f <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />1/0{ <br /> <br />;J)/Utj(IP <br />() <br /> <br />COMPANY ~'KL-+ <br />STATE CERT OR REGIST # CF~'-I~ 99 f <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />******************.************************~*****~************ <br /> <br />1/ .. . . COMPANY - l. ~ 11/)-1 AI J(1-bu . <br />Un<- m{U~ STATE CERT OR REGIST # CACLJ5/"'J 4/0 <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />* *** *;;** *** ** * ** * *.* *. * ** * *** ** *::~:~;: * 2* * ~*~'2'*~+- <br />1(/~ !J)tL~ STATE CERT OR REGIST i 'lC/j!,-!;O/3 <br /> <br />OTHER <br />