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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 l::!t q j <br />DATE RECEIVED Qj _IDe:; <br />, <br />~hr\ U uel~ <br />PHONE CONTACT FOR PERMITTING ~13-qL~-~ <br /> <br />~~gz <br /> <br />,'!v6l3 '}I3 <br /> <br />OWNER'S NAME <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />1f13'i <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK -1!5 <br /> <br />o - (::JC( () <br /> <br />SUBDIVISION W..i.f-vLtiAJ <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 />OSIGN <br /> <br />o MOVE <br /> <br />o DEMOLI SH <br /> <br />PROPOSED USE: ~SGL 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 />BUILDING SIZE <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />0--'_0 S& <br />5J 1C .3ca.~ <br /> <br />UCl#1U~~ ~~:r- <br /> <br />SQUARE Fa TAGE t9L3[)~ . <br /> <br />HEIGHT <br /> <br />17fl- <br /> <br />DESCRIPTION OF WORK <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 />~BUILDING <br />~ELECTRICAL <br />~LUMBING <br />~MECHANICAL <br /> <br />$ <br /> <br />PERMITS REQUESTED <br />Jc;J~1 ~~[) VALUATION OF TOTAL CONSTRUCTION <br />6tD <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy ~ <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />~~ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />~OFING 0 SPECIALTY <br />OF CONSTRUCTION: if BLOCK <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />J3J.C/) <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />TYPE <br /> <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />)l)0 <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />:5 <br />Cl3c ot../tfi&9j <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />************* **************************************************** <br /> <br />SIGNATURE <br /> <br />q/{[ <br /> <br />! Odt& <br /> <br />(j <br /> <br />COMPANY Ed /YI~Y;;t\r- <br />STATE CERT OR REGIST # 00/3/3 .V- <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />~ <br /> <br />^Cb~ <br /> <br />COMPANY ~'K-JL-.+ <br />STATE CERT OR REGIST # CF~'I~ 99? <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *::iF * * * * * ~ * * * * * * * * * *.* * <br /> <br />. 1 COMPANY . l. ~ ~~A Al J().~ . <br />& ^ OIL1l./z0 STATE CERT OR REGIST * Ci't(~/)A/LO <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />** ***;;*** *** *** ****** *** ** *** **e~~:::*C: .~.~~* *~+-- <br /> <br />;1)1/X Af)~ STATE CERT OR REGIST * 1!e..;;;;Jf{);3 <br /> <br />OTHER <br />