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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATiU~ <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DA'fE RECElVED <br />PHONE CONTACi' FOR P~RMITTING tfS ~r, '7'79 p. <br /> <br />OWNER'S NAME (Y),q J ~ ';) -Z :C <br /> <br />" <br /> <br />JOB ADDRESS J'15~L, <br /> <br />~ <br /> <br />A", <br /> <br />Jof- <br /> <br />PHONE (,qs--9CJ96 <br /> <br />)9/2 <br /> <br />c' A t\:.,J <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br />() 0 f:Jc (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />PARCEL 10 # <br /> <br />';;)4 -~~ - ~/-OCJOD- CO)O(j <br /> <br />i <br />WORK PROPSED: ~ CONSTRUCTION <br />DSIGN <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INsTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <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 />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 & (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 /> <br />0 BUILDING <br />0 ELECTRICAL <br />0 PLUMBING <br />0 MECHANICAL <br />0 GAS o ROOFING <br /> <br />$ /'c:,[YJ'-' e c" <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <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 />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br />~-:;:>? ~ <br />OTHER/l D5L/'/~ ~~~ COMPANy/c05Lyi//O ,(?c7h~e, <br /> <br />SIGNATURE ~_ _/C::-'--:;-~ ~ _ /1 _ ~ tJ" <br />- - - ~-- --------- STATE CERT OR REGIST # ~ ~~) <br />~/-~ <br />