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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 /> <br />PHONE CONTACT FOR <br /> <br />PERMITTING ~l ~r 1'l~ ~ 2f3/'J <br />,,\1tu> L\ 0bL <br />PHONE g!3 ~ gg:z. - j-f&:?(k_~ jCi3, <br /> <br />iu, lie'( r 1-/J/'i/5, Jl(!; <br />JOB ADDRESS ,$OCn f'0.er%(\+'\J \ \ \e u i r Q (J <br />LEGAL DESCRIPTION: LOT(S)lI;D BLOCK-&- SUBDIVISION WJx.f-viuJ <br />PARCEL 10 # :;).f)- f}S-- 21-0 \2'0- o(lYt)-.6 ri.ocD' (OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />OWNER'S NAME <br /> <br />WORK PROPSED: I:ll NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />OSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OOSGL FAMILY DWELLING <br />DCOMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br />BUILDING SIZE ~. Co x:. <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />l5i 0 S& <br />yo <br /> <br />UI7")((~_ ~~( /1r- <br /> <br />SQUARE FO TAGE _[9, d ' <br /> <br />HEIGHT ___ <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~BUILDING <br />~ELECTRICAL <br />~PLUMBING <br />~MECHANICAL <br />o GAS ~OOFING <br /> <br />$ <br /> <br />l [)<? } YLOD <br />dC() <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy ~ <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />~\ , QCO, - <br /> <br />, <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: ~BLOCK <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />fd7.oo <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />~O <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />/ <br />Cl:3e i:JI/ (t:1&9j-- <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />*****~************************************************* <br /> <br />SIGNATURE <br /> <br />. ~ 01 <br />COMPANY Cc. InOfJ....Y;JYI......-- <br />:).:>1 <br />~ STATE CERT OR REGIST t 00/", lJ 'f <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />k ~ COMPANY Iiu;VkL+ . . <br />~ STATE CERT OR REGIST # CF~l!J Sf(/ &,/ <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />******************************************~***~it;;********.**** <br /> <br />r. COMPANY. ~ ') - /1)J:{) JO hu <br />U IX A Cb~ STATE CERT OR RF.GIST B CI1CtJ5t'/ A/ 10 <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br />I <br />~ - COMPANY C. 01-r/i {U1:t- ~t- <br />. : J..-l~ ,.1 <br />! STATE CERT OR REGIST # .l1e/1 s /() /__ <br /> <br />~- <br /> <br />OTHER <br />