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<br />t <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aTH st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />PARCEL 10 # <br /> <br />Lu1 nay Y-brus, Jr!6 <br />15'-/5 weehawl<u\ Off ve.- <br />~5 <br />a '5 e:). c:; .,.,2/ I () J ~ () - ()(){)C() ., oj 50 <br /> <br />PHONE <br /> <br />8'3' ~g2 - Q(P63 fl3 <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />-- <br /> <br />SUBDIVISION 6u..l-fl/~ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: rilSGL FAMILY DWELLING <br />o COMMERC IAL <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 />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK .St nsU d(JU1U~. ~}~~u <br />BUILDING SIZE 4D' )( ,,~' SQUARE FO ~AGE _,il~t/tf <br /> <br />HEIGHT <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 />o BUILDING <br /> <br />$ <br /> <br />/t./ 0 I 000 , DE. <br /> <br />, <br /> <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 />if; ()tf). DJL <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION: ~BLOCK <br /> <br />o OTHER <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS /37. 5D I <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />5 <br />Cl5c 01 b;&9~ <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />******************************************************* <br /> <br />ELECTRICIAN~ . <br />SIGNATURE . ~ <br /> <br />AOan tfh <br />'I <br /> <br />COMPANY [}I/yUJfl 'YJt{___ <br />STATE CERT OR REG 1ST # 00/3/3 f- <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />~r}t <br /> <br />l D04( 1-& <br /> <br />COMPANY ~-I- <br />STATE CERT OR REGIST # CF~L/J 91 f <br /> <br />PLUMBER <br /> <br />'l:GNATURE <br /> <br />******************************************~*****~************ <br /> <br />~. COMPANY. iL~ '/>y'1Al r~ <br />, ()( JOI'I1'/10 STATE CER.' OR REGIST # CACDS/J 4/ [) <br /> <br />MECHANICAL <br /> <br />/ <br /> <br />***************************************************************** <br /> <br />COMPANY C. ~bId:- ~~ <br /> <br />STATE CERT OR REGIST # IlC./-I ~- . 0 /3 <br /> <br />-K'M- ;.thu r};? <br /> <br />I <br />