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<br />,0..0.. \. <br /> <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 />PHONE CONTACT FOR <br /> <br />DATE RECEIVED ~ <br />Jchf'\ ~~l \~I . <br />PERMITTING ~\..3-ql~~dS.3~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />Lu,()ar Y-hft/S, U16 <br /> <br />JOB ADDRESS '7 C5<( ~C~U~\\e <br />ID'-{ <br />PARCEL 10 # 3If:J - dO - ~) ~ <br /> <br />PHONE <br /> <br />OWNER'S NAME <br /> <br />~~\ (~e <br />BLOCK ~_ <br />(/>- I~O <br /> <br />SUBDIVISION 6u..l.fvu..vJ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />:.J DEMOLISH <br /> <br />PROPOSED USE: ~SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILI <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 />D <br />U/I) S& <br />lO'5X4D <br /> <br />RESTAURANT & HEALTH DEPP <br /> <br />Ut7B1U~ ' <br />SQUARE FO TAG <br /> <br />"'1ENT APPROVAL <br /> <br />f}I/-( LI!t ~J <br />d~4- <br /> <br />HEIGHT ~e~ ~ <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) SST ENERGY FORMS, <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />iF Lf3 q D <br /> <br />$ <br /> <br />'~9 )qOO <br />dCO <br /> <br />PERMITS REQUESTEr <br /> <br />~UILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />AMP SERVICE 0 Progress Energy ~.R,E,C. <br /> <br />~ECTRICAL <br />~MBING <br />~~HANICAL $~'~()() VALUATION OF MECHANCIAL INSTALLATION <br />o GAS ~ING 0 SPECIALTY 0 OTHER <br />TYPE OF CONSTRUCTION: ~BLOCK 0 FRAME <br />FINISHED FLOOR ELEVATIONS J!:J3 ,[J) <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />[J;J...We-- <br /> <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />5 <br />CSC D1bJ&9ii <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />******************************************************* <br /> <br />SIGNATURE <br /> <br />Jim <br /> <br />^Oa~ <br /> <br />COMPANY &1 fY){]J1.Y;JL <br />STATE CERT OR REGIST # 00/3/3 f <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />~ <br /> <br />;JJ~ <br /> <br />COMPANY ~+ <br />STATE CERT OR REGIST # CF~i../d 99 f <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />* * * * * : * * H * * * * * * * * * * * * * * * * * * * * * * * * ~~~;~~~ * :;tF.* * L~P ~'ft 7> *iDk <br /> <br />.kclt tf)~ STATE CERT OR REGIST # CItCD.:;;:2 4/0 <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />.. .... 'JHj ...... .:~..... ........ .:~~:::: '(i~'~'b;;:H~ <br /> <br />1\ttU (AJ}!LfvI:tJ STATE CERT OR REGIST # fie/I ~-o /3 <br /> <br />OTHER <br />