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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 ~11~l^r- <br />DATE RECEIVED ~ -~,.(\ <br />~cn() Uvel~ <br />PHONE CONTACT FOR PERMITTING "8l~-91~'dS3~ <br /> <br />LLnfJtbr Y-hft/S, LA1~ <br />JOB ADDRESS ~11:2 fYlcrch1nivt' f 1e.Cud:P <br />LEGAL DESCRIPTION~ LOT (S) 13'8 BLOCK # <br />PARCEL I~ # :!:b dS ~dl - - (/J -l3<6u <br /> <br />OWNER'S NAME <br /> <br />PHONE <br /> <br />~ gg2.- <br /> <br />,II /1.3-:f13 <br /> <br />SUBDIVISION W...l.f-l/LtuJ <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 />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: CilSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-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 /> <br />DESCRIPTION OF WORK WI" s& \ iclN.lir ~il.( /.L< ~U- <br />BUILDING SIZE Lod)( LfO SQUARE FO TAGE~ HEIGHT ~f t <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 />PERMITS REQUESTED <br /> <br />:t(,BUILDING $ III / J DO <br />~CO <br />~ ELECTRICAL <br />jJ('J PLUMBING 3CDo <br />J'1 MECHANICAL $ <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />o Progress Energy i( <br /> <br />W.R.E,C. <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS ~OOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION: ~BLOCK <br /> <br />o OT HER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />13). ~O <br /> <br />o STEEL <br /> <br />o OT HER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />)r'NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />:5 <br />CI3 C D;Jb; & 9 J <br /> <br />I <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />~ <br /> <br />;{ OiU1jdL <br /> <br />COMPANY &! fYJO/l~ <br />STATE CERT OR REGIST # DO /3/3 'f <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />t:~, Ji)~ <br /> <br />COMPANY ~+ <br />STATE CERT OR REGIST # CF~IjJ, 99 f <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ::iF * * * * *.h * * * * * * * * * *.* * <br /> <br />/0; . ' COMPANY. l\...~ '.#flU) J(j~ <br />.. ! I!{ ,J. O~ STATE CERT OR REGIST # CACLJ-s/J /fIO <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />......~.;. H.................~. .::~:::. C" ~ .~;. .~ <br /> <br />~ )])dL/-tt;! STATE CERT OR REGIST # flc:.l-l~- 0/3 <br /> <br />OTHER <br />