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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 REC&VED <br />~'-'\1e~ <br />PHONE CONTACT FOR PERMITTING ~\O -9l""d'~ <br /> <br />PARCEL 10 # <br /> <br />LLn (Jar 'l--bftlS, LM6 <br />'7 go 5 f'f\e(r ~', \ \e C. \ rc"\<=" <br />~ BLOCK (2) <br />?:f::y C)n- Z (- 0 I J-fJ - O()OOO - D 3;;L D <br /> <br />PHONE 813 - CZ g:z.. - ,;.f&63j13 <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />SUBDIVISION W.s..f-l/Lu.J <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 />OSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: rilSGL FAMILY DWELLING <br />o COMMERCIAL <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 />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK lS-o S& \2CZI'1l'1:1r W-' )~.tI!r a;- <br />BUILDING SIZE yq.u> '( ~O SQUARE FO TAGE \C\ld HEIGHT ~ <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 />L(5tl <br /> <br />PERMITS REQUESTED <br /> <br />~UILDING <br />~ECTRICAL <br />~MBING <br />8"MECHANICA~" <br />o GAS ~OOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION: ~BLOCK <br /> <br />$ \D<?) ~loD <br />d)o::j <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />AMP SERVICE 0 Progress Energy ~.R.E.C, <br /> <br />$~DD <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o OTHER <br /> <br />o FRAME <br />FINISHED FLOOR ELEVATIONS ~~.~() <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />~ <br /> <br /> <br />STATE CERT OR REGIST # <br /> <br />5 <br />Cl3c 01 ~&9j <br /> <br />SIGNATURE <br /> <br />4aAu~ <br /> <br />.1)tU/ db <br /> <br />u <br /> <br />COMPANY <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />,;(~ ~ 4ltuy:t'R <br /> <br />COMPANY &I /Y10.fl ~ <br />STATE CERT OR REGIST # 00/3/3 Y- <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />~iwJ; <br /> <br />JJmf;!U <br /> <br />i/ <br /> <br />COMPANY ~+ <br />STATE CERT OR REGIST # CF~'-Id 99? <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />**********************************~~~;:~~*~:*~~ij;~,j;~J(j*~ <br />~~ JC.OtUlJ.tttl STATE CERT OR REGIST . CIILL)S/J-'I/O <br />(./ <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />~************~*:**~:~::;:*e**~'Z;;;'*~ <br /> <br />(~ STATE CERT OR REGIST . t1~4I~l?/ <br /> <br />OTHER <br />