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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATiUN <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />{' <br /> <br />DATE RECE IVED <br />PHONE CONTACT FOR PERMITTING 6~:3-~ ~~ <br /> <br />OWNER'S NAME {Y).q "J i:.S--Z:C (}A \""C.,I <br />JOB ADDRESS 3 '15~;;2- C~YJ.J <br /> <br />Rl () <br />~ ~f/) <br /> <br />PHONE 'qs-~ <":;99 t <br />~ I~ <br /> <br />SUBDIVISION <br />() (.)?C (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />Pl1RCEL I D # ';;;) 4- - ~ ~ - c9- J -00 OO~ CO) 00 <br /> <br />, I <br /> <br />WORi PROPSED: ~ 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: OSGL 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 />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERC1AL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <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 />$ /'~ LX) "e> C.. <br /> <br />VALUATION OF TOTAL CONSTRU <br /> <br /> <br />FORMS. <br /> <br />PERMITS REQUESTED <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 />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o 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 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <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 />***************************************************************** <br /> <br />OTHERgX,../~ ~h~ COMPANy~ZY'//D (?c7h~e <br />/~ /'--:::? ~I <br />SIGNATURE'/'..... {' _ ,/(-.,.' (-~ <br /> <br />STATE CERT OR REGIST # <br /> <br />2-,/f~)- <br />~/-~ <br />