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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 STH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-7S0-0021 <br /> <br />DATE RECEIVED <br />~U\le\'1 . <br />PHONE CONTACT FOR PERMITTING ~ \~-q \1 -cil63Q <br /> <br />ILn nar I-hms I LM6 <br />JOB ADDRESS 7~A.1 \y\-c:::rchc;)r..'\-\1l\ \~ a C(rz <br />LEGAL DESCRIPTION: LOT (S) 3"l BLOCK C/J <br />PARCEL 10 # 2:t:r<9'E:y<!) \- ~- Ci:> - 0610 <br /> <br />PHONE 813 - ?5 g2.. - J-j&63 'f/3 <br /> <br />OWNER'S NAME <br /> <br />SUBDIVISION W..l.f-l/LtiAJ <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: IiSGL 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 />BUILDING SIZE <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />~(JS& UtJU'lU~. 0iJ/).tU{{~ <br />~ 'I. D~ ~ SQUARE FO TAGE ~ <br /> <br />HEIGHT ~ <br /> <br />DESCRIPTION OF WORK <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (I) SET ENERGY FORMS, <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (I) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />ZOING PERMITS REQUESTED <br />$ \ \~OO VALUATION OF TOTAL CONSTRUCTION <br />ELECTRICAL ~ AMP SERVICE 0 Progress Energy ~W.R.E,C. <br />~MBING <br />~HANICAL $#?ro VALUATION OF MECHANCIAL INSTALLATION <br />o GAS ~OOFING o SPECIALTY 0 OTHER <br /> <br />TYPE OF CONSTRUCTION: Kt'BLOCK 0 FRAME <br />FINISHED FLOOR ELEVATIONS ~.'::i) <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~ <br /> <br /> <br />STATE CERT OR REGIST # <br /> <br />:5 <br />Cl3c o1~&9j <br /> <br />SIGNATURE <br /> <br />7/akJj;; <br /> <br />}. (};i/.ty#J <br /> <br />COMPANY <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />~4 <br /> <br />. n COMPANY Ed f'()f1/7..... Y;h(j <br />jJ)~ STATE CERT OR REGIST # 00/3/3 'f <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />cj{rJiJ4 <br /> <br /> <br />***** *** * * * **** ** ****** * * * * * * * ** ** **** ** **:;;.F* * ** * b.. * * * * * * ** * *..* * <br /> <br />~ Jl COMPANY. ~ '\ 'P/1U) fl ~ <br />ta...itt4 !J)~ STATE CERT OR REGIST # CACLJso ~/ 0 <br /> <br />;l)~ <br /> <br />COMPANY ~+ <br />STATE CERT OR REGIST # CFGOL/J, 99 f <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />...:;....... *...: ~ :......:. .::~::;:. e" &;;Z;;;' H~ <br /> <br />~;~ ,IUA:l.U.~ STATE CERT OR REGIS" * 11c./-Is-{) /3 <br /> <br />OTHER <br />