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<br />CITY OF ZEPHYRHILLS PERMIT APPLICAT~UN <br />BUILDING DEPARTMENT 5335 8TH st, ZephyrhillS, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED- <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />{Vlft~~c;7iC ~frKS' <br />'3/~ .~n~ <br /> <br />{Ju <br />. '1 <br />C}~ ~ <br /> <br />BLOCK <br /> <br />PHONE <br /> <br />Cfi 5'.L19q~ <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL ID #2 <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED: <br /> <br /> <br />. ()c:J90 <br /> <br />CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />OJ <br /> <br />OSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: oSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o~ <br />D( <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAURANT <br />I::LJL 5f) <br />. <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />D,i{~Y <br /> <br />SQUARE FOOTAGE ~t:) <br /> <br />BUILDING SIZE <br /> <br /> <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SEy'EN~ <br />FORMS. / // <br />/ ------- <br /> <br />q~1~ <br /> <br /> <br />PERMITS REQUESTED <br /> <br />] BUILDING <br /> <br />$ / lAY:) , (;)c;) <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />] ELECTRICAL <br />] PLUMBING <br />] MECHANICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C <br /> <br />] GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />$ <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <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 <br /> <br />COMPANY <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 />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER ~""""""""""'~~~::::'~~'~;;~j::"~~ <br /> <br />SIGNATURE~'-e-,pb STATE CERT OR REGIST # '2---I-f~ <br />