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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 STH st, ZephyrhillS, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />JOB ADDRESS <br /> <br />LLn ()tbV Y-bft/6, LM~ <br />1531 J01D ~+rat <br /> <br />LEGAL DESCRIPTION: LOT(S) lID BLOCK / SUBDIVISION W..l-fVuv) <br />, <br /> <br />35'~c.:::.-o-l-D):LO.CDDCb. JJ~ (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />PHONE <br /> <br />8'3 - g g2- - J-/-(P63113 <br /> <br />OWNER'S NAME <br /> <br />PARCEL ID # <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: l:iI SGL 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 <br />LSI.o S& <br />X50' <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />tJON/~, 0.~~t~J <br /> <br />SQUARE FO TAGE ,;1,301 <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF WORK <br /> <br />3f )8" II <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 />$ <br /> <br />PERMITS REQUESTED <br />1~7/"bl).D~ VAL?ATION OF TOTAL CONSTRUCTION <br />AMP SERVICE 0 Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />, I. Il.^D.'2- <br />91 ~- VALUATION OF MECHANCIAL INSTALLATION <br />o SPECIALTY 0 OTHER <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />TYPE OF CONSTRUCTION: ~BLOCK 0 FRAME <br />FINISHED FLOOR ELEVATIONS 1.:l~:2~' <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />o NO <br /> <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />s <br />03c 01 &&9j <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />********************************************************* <br /> <br />, <br />ELECTRICIAN c4r <br />SIGNATURE -:: i It'l <br /> <br />IJ <br />. dll rtft) <br /> <br />( <br /> <br />COMPANY Ed mOJ/.... ~--- <br />STATE CERT OR' REGI~T # 00/3/3 'f <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />A)lUJL7'lb <br /> <br /> <br />* * * * * * * * * * * * * * * * * * **. * * * * * * * * * * * * * * * * * * * * * * :;tF * * * * *.p * * * * * * * * * * * * <br /> <br />~ \ COMPANY. Q q '41tAl JD~. <br />'" }t f- )!1?P& STATE CERT OR REGIST # Ci4-(1)5/J 4/0 <br /> <br />/ <br />~(1X <br /> <br />COMPANY ~+ <br />STATE CERT OR REGIST # CF~L/J 99 f <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />m;;.mm;:"HmmHH'H:~~:::'(i'HJi~7:;;H~ . <br /> <br />-/ flit AVdL{f tIP STATE CERT OR REGIST * IlCJ--/S HO <br /> <br />OTHER <br />