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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 RECE IVED <br /> <br />7-?-oS;- <br /> <br />PHONE CONTACT FOR PERMITTING 780 -.2. 22..1 <br /> <br />OWNER'S NAME <br /> <br />L: D )9r/?o T ~I' <br /> <br />JOB ADDRESS <br /> <br />s-/s 2- <br /> <br />./ I <br /> <br />s-t- <br />c,f- <br /> <br />'f- ~\ oc.. V'- A rVlot PHONE <br />::2"f!'QJU'"7)'l:JJS, J I":' Ie.... <br />BLOCK SUBDIVISION <br /> <br />78'"2.... - /173 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br />PROPOSED USE: ~ FAMILY DWELLING <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK ~,..OC/~~/ <br />BUILDING SIZE <br /> <br />/~J / ,,)4. <br /> <br />~~ <br /> <br />~ar Sh..J-,O~J <br />o <br /> <br />SO~ <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 />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <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 $ ~S-OO, oe VALUATION OF MECHANCIAL INSTALLATION <br />o GAS ~OFING 0 SPECIALTY 0 OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />o NO <br /> <br /> <br />BUILDER ~ <br />' . /' <br />S~Cm'.TtJt\t;K-~~"'~ <br /> <br />STATE CERT OR REGI <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />*******************************************************:*****j7** <br /> <br /> <br />OTHER ~ COMPAN~r.17''{...--S ~c1;;' C7 4 c <br />/" ' /~ C7 <br />SIGNATUREA-/~~ ___ STATE CERT OR REGIST # 7Ca:Y2c1119 <br />