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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 />.)c:h(\ \:\\Je \~ <br />PHONE CONTACT FOR PERMITTING ~\~-q\<l. 1.~ <br /> <br />OWNER'S NAME <br /> <br />LLn (Jar Y-f;/'iIS, LA1~ <br />JOB ADDRESS 7$3 S \'1le(l''(v\C'\~"i \ \~ ~ C-jP- <br />LEGAL DESCRIPTION: LOT(S) 2)~ BLOCK (2) <br />PARCEL 10 # ~"'d~"'2.\....$S~-~-~ <br /> <br />PHONE <br /> <br />g/3' CZ g2 - J.j&63113 <br /> <br />SUBDIVISION W..s...-f-l/UtAJ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION o ADDITION OALTERATION o REPAIR o INSTALL <br /> OSIGN o MOVE 0 DEMOLISH <br />PROPOSED USE: CilSGL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />BUILDING SIZE <br /> <br />~)(.lo~ <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />&0 S& UCZuXt ~ - ~ J~1J- <br /> <br />SQUARE FO TAGE f).;;););). HEIGHT <.6 f-\ <br /> <br />DESCRIPTION OF WORK <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 />~LDING <br />r:{ ~CTRICAL <br />Iif'?UMBING <br />ef MECHANICAL $ b~ <br />o GAS ~OFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION: if BLOCK <br /> <br />$ \~~. bllO <br />I <br /> <br />dCQ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy <br /> <br />~ <br /> <br />W.R.E,C. <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />\L\2.QO <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~O <br /> <br /> <br />STATE CERT OR REGIST # <br /> <br />:5 <br />CI3C 01 (;fl&9j <br /> <br />SIGNATURE <br /> <br />=J/a)~ <br /> <br />JJM~ <br /> <br />COMPANY <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />~jAA4; <br /> <br />ill COMPANY f'd f(lOJ1. 'OK- <br />. '4.11~STATE CERT OR REGIST * 00/3/3 f- <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />SNATURE <br /> <br />,/ A n COMPANY J0~If)u-l <br />=jlctfll.iJ4 JY~ STATE CERT OR REGIST * CFGO'/J, 99 i? <br /> <br /> <br />* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * */t * * * * * * f * * * * * * * * * * *.* * <br /> <br />f / fl COMPANY --Zf- ~ 31211-/)1 AI JO-l:w..e- <br />9[1iuJ~J ~ STATE CER'!' OR REGIST * CI't~,/)/fLO <br /> <br />"': ;:' '" ~' "~~..." "=:~" :~~:~;: 'c' '&~Hb;;'H~ <br /> <br />'j\~ ~ STATE CERT OR REGIS" # ':fie/I !,-o /3 <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />THER <br />