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CITY OF ZEPHYRHILLS PERMIT APPLICATiU~ BUILDING DEPARTMENT 5335 8TH St, Zephyrhi11s, FL 33542 813-780-0020 FAX: 813-780-0021 PHONE CONTACT FOR DATE RECEIVED (P/21 / tJ S- PERMITTING ff(3-Zh 7- ~~oz--- OWNER'S NAME fA /$ IAAflt1 U-- 79l Dr PPlt W. PHONE ff/3 -783-- if/~Y- JOB ADDRESS LEGAL DESCRIPTION: LOT(S) BLOCK # rl .- 7-10.- Z( - YJ\ 'd..() - ao 'D6 i_i)'" g () PARCEL ID ~~/. U SUBDIVISION Ziylyv . U1Ell:1.wrS (OBTAIN FROM PROPERTY TAX NOTICE) WORK PROPSED: o NEW CONSTRUCTION o ADDITION OALTERATION o REPAIR o INSTALL o SIGN o MOVE 0 DEMOLISH PROPOSED USE: OSGL FAMILY DWELLING oMULTI-FAMILY 0# OF UNITS o MOBILE HOME o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER DESCRIPTION OF WORK c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL ~l1z- ,JfIv1/UI '1tmlr NIL tV ~ v(s H-- 6f€fJJfJ cr BUILDING SIZE SQUARE FOOTAGE HEIGHT RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. #'5 l , )'" ~UILDING o ELECTRICAL o PLUMBING o MECHANICAL $ ?Sb . 1.3 PERMITS REQUESTED VALUATION OF TOTAL CONSTRUCTION AMP SERVICE o Progress Energy o W.R.E.C. $ o GAS o ROOFING o SPECIALTY VALUATION OF MECHANCIAL INSTALLATION o OTHER TYPE OF CONSTRUCTION: 0 BLOCK o FRAME o STEEL o OTHER FINISHED FLOOR ELEVATIONS IS PROJECT IN FLOOD ZONE AREAD YES 0 NO i_"::~~~~~_~_~~:~~~~,~~~~_=~~~~~~~_..:_:.--~~~-~~~W,-. ~_~-_ ____ _ - _ _ _ _ _ _ _ '_~~~:_ -:._' :~;_~~~~_-~~~~_-_~~~~-~~=--,~~:;~~:;~~?c BUILDER COMPANY SIGNATURE STATE CERT OR REGIST # ****************************************************************** ELECTRICIAN COMPANY SIGNATURE STATE CERT OR REGIST # ****************************************************************** PLUMBER COMPANY SIGNATURE STATE CERT OR REGIST # ****************************************************************** MECHANICAL COMPANY SIGNATURE STATE CERT OR REGIST # ***************************************************************** OnlER ~Y\J.i~ l-htN.- ~ I f>/L..-- COMPANY ~ IS ~ ~ 1M SIGNATURE /) 7JvJU . ~ ... STATE CERT OR REGIST #- C(qL 15'0 i <f r;