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<br />CITY OF ZEPHYRHILLS PERMIT APPLICAT~U~ <br />BUILDING DEPARTMENT 5335 8~H St, Zephyrhills, Fl, 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />~ -7-o.:J <br /> <br />PHONE CONTACT FOR PERMITTING <3(6-' ~ I 't ~ ) 'J7T <br /> <br />PM! ,Suit4c <br />S7 ~ y, y ~ st- <br /> <br />LEGAL DESCRI PT ION: LOT (S) t5;}( 6 <br /> <br />OWNER'S NAME <br /> <br />PHONI~ JI:S-ll ~-J-bi7 <br /> <br />JOB ADDRESS <br /> <br />BLOCK <br /> <br />OJ rOD SUBDIVISION (Jol D <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />[] REPAIR <br /> <br />E3-"f'NSTALL <br /> <br />OSIGN <br />PROPOSED USE: ~L FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <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 />DESCRIPTION OF WORK <br /> <br />CJ <br />;J;v -:;hUL <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />A}" k,} -s~ i:clv<is - <br /> <br />SQUARE FOOTAGE 1'19 Jl <br /> <br />HEIGHT <br /> <br />t?" <br /> <br />BUILDING SIZE <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 />J!~~~ t ~t <br /> <br />PERMITS REQUESTED <br /> <br />'"----.._._....,_....._~'-,..-._^" ,.... .". <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E,C, <br /> <br />o PLUMBING <br />~CHANICAL <br /> <br />$ <br /> <br />s-ooo <br /> <br />~ <br /> <br />'\ <br />\ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />/ <br />VALUATION OF MECHANCIAL INSTALLAT~?~ ~ <br />o OTHER ( 1('39, <br />9"'FRAME 0 STEEL 0 OTHER ~ <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />~~,~,/y <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />******************************************************~,*********** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANI~******:'**i7*'*:***************~~~;~~;*****)lt~;~**~~. LLC~ <br /> <br />SIGNATUR~~/~ STATE CERT OR REGIST # . <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />