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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 RECEIVED <br /> <br />~/t/o5 <br /> <br />PHONE CONTACT FOR PERMITTING <lOO. i Ie - ~ 7I2 <br /> <br />~rJ' Moofe <br />~;d9() <br /> <br />511<, <br /> <br />s-t-, <br /> <br />7/5- ~ s S' 0 <br />..l'epny,ehIJb ::fl. <br />SUBDIVISION. ShAaJs J.."~. ~,J$L <br /> <br />PHONE <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S)~ BLOCK~ <br />PARCEL ID #-.1D2b.21 00...0 eD'OO O/~-o <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~EW 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: DSGL 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 />])( OT HER <br /> <br />BUILDING SIZE <br /> <br />c:J RESTAURANT & <br />~Oft) s+~ Met <br />24 )t .2+ <br /> <br />HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />de+~theJ <br /> <br />~ .tH~. Aj e... <br /> <br />tve4 f~ <br />VNlAa~ <br />/lJ ' <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FqRMS, <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. :::J " ))\:::::> <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. ~ n ~\/I' <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTI~ /1 \~ > \') <br /> <br /> <br />PERMITS REQUESTED r t/ <br /> <br />)it BUILDING $ 2:2, ~t)t) aJ VALUATION OF TOTAL CONSTRUCTION <br />o ELECTRICAL AMP SERVICE 0 Progress Energy [] W.R.E,C. <br />o PLUMBING <br />o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION <br />o GAS )(ROOFING o SPECIALTY 0 OTHER <br /> <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK ;B1 FRAME <br />FINISHED FLOOR ELEVATIONS ,," A 1,1e.. ~t fl~e... <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />o NO <br /> <br /> <br />BUILDER ~ ,g, COMPANY MlIstee G"r"'je 'Bl.lR.s ' <br /> <br />SIGNATURE H'~:H'~'" HHH...... :~~~:.~::~ .~:.::~~:~.:. .:~~..~ S 7 aSK <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 />****************************************************************** <br /> <br />MECHANICAL <br /> <br />OTHER <br /> <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />************************************ <br /> <br />COMPAN~b ~Jw ' <br /> <br />STATE CERT"~a:.RidiSr~yl'() R)C;:Q'tf7 fJs- g <br />