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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 eTH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />Lu, nay- I-hIY/S. LA1~ <br />1 (P03 Jet16.S/l-red- <br />J{)7 <br />.35'" &S=- -a-/~ D/dO. ODCDO - /D7 <br /> <br />PHONE 813 - ~g2 - .i-f&63 jl3 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />--- <br /> <br />SUBDIVISION W..l-fvit.iAJ <br /> <br />PARCEL 10 # <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 />BUILDING SIZE <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />~ () s<'~ Ui2N1~~ wJ1 )-t/!L{;;:;- <br />LID I X fe,/)' SQUARE FO TAGE ~d:l~a <br /> <br />HEIGHT <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 />o BUILDING <br /> <br />PERMITS REQUESTED <br />/J:Z I O"J... I ()O <br />$ _ ,. ~ VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />L.t ^OD. OL <br />~ ~ VALUATION OF MECHANCIAL INSTALLATION <br />o SPECIALTY 0 OTHER <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />TYPE OF CONSTRUCTION: ~BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS /31:, ISD · <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />s <br />aC o1i?&9j <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />********************************************************** <br /> <br />ELECTRICIAN" / <br />SIGNATURE ~1X~0 <br /> <br />., <br /> <br />i!tU)t17tJ <br /> <br />COMPANY i'd/YIO~L--- <br />STATE CERT OR REGIB.T # 00/3/3.'1 <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />/ <br /> <br /> <br />~~ <br />r'j ij)l() / <br /> <br />iLJL;/it& <br /> <br />COMPANY ~+ <br />STATE CERT OR REGIST # CF~i./d 99 f' <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />* * * * * *.* * *.* * * * * * * * * * * * * * * *.* * * * * * * * * * * * * * * * * ~ * * * * * ~ * * * * * * * * *. *.* * <br /> <br />'. ,,' COMPANY. L ~ VJ1JI.A"} J{J~ <br />tfL ' . L ~ . <br />. ( J"lI-l--lA 0 A 04@J STATE CERT OR REGIST # Ci4CLJ5/J 4/0 <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br /> <br />J; -,- COMPANY C &mk1!J. ~~ <br /> <br />riliftf2/ STATE CERT OR REGIST # Ilc..l! .5,-0/3 <br /> <br />i{v~D1.0 <br /> <br />OTHER <br />