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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 <br /> <br />DATE RECE IVED <br /> <br />s- 4hs- <br /> <br />/ / <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAM~O~ ~.&::~~ ~ <br />JOB ADDRESS J-.~ ,4 /1.. ~ <br />LEGAL DESCRIPTION: LOT (S) () 550 BLOCK ~ SUBDIVISION f)(60 <br />PARCEL 10 # 3~-,;;).5 -dJ-O /30~~-Os(j/O <br /> <br />f?/~-~ 7c?~ -O<fdS <br /> <br />PHONE <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE\ <br /> <br />WORK PROPSED: ~W CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br />PROPOSED USE:tJSGL FAMILY DWELLING <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <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 />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK ~ oS ( vi <i I e.., +~ l'j:.. ~~; C~ <br />BUILDING SIZE ::!S/9/cf // X .t.f7'/ 'If.( SQUARE FOOTAGE J ~~fY HEIGHT &' ~ <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 />--1==1 O--nyp 4-i'KL ~ l \ ~ G-o\ ~{ Ie <br />PERMITS REQUESTED <br /> <br />~DING $ /;;( ~ O~O ~ VALUATION OF TOTAL CONSTRUCTION <br /> <br />~CTRICAL <br />~UMBING <br />~HANICAL <br />o GAS ~NG <br /> <br />c.-:7Z. ~D <br /> <br />AMP SERVICE <br /> <br />~ogress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />35D80= <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION:~ <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 ~ <br /> <br /> <br />BUILDER ~ j) 1/ I: \ ~. r- <br />SIGNATU~~ STATE eERT OR REGIST <br /> <br /> <br /> <br />SIGNATURE ( " If STATE CERT OR REGIST # E R OO{J-/&91 <br />********** ***************************************************** <br /> <br />SIGNATURE <br /> <br /> <br />~.. d r' COMPAN~De.YVY\.;&..lAJ ll\l~.s ~/~, <br />, ~p STATE eERT OR REGIST i~J=C. 1~f5 boa. <br /> <br />************:**************************~***l**~**~******* .0 <br />COMPANY ~r So YrD po n e. '-\ 4 OL.-J <br /> <br />STATE CERT OR REGIST #~A-c. D'-fS '-I9? <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />OTH'R&<~ <br /> <br />SIGNATURE~ n _~ <br /> <br />*2* **********::~:::~*~~lr~ <br /> <br />- ~ STATE CERT OR REGIST # ~ /3~65'D5 <br />