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<br />@ <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLIC~.1.'..LUL'4 <br />BUILDING DEPARTMENT 5335 aTH st, Zephyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DA'I'E RECEIVED <br />PHONE CONTACT FOR PERMITTING .,f~ '~.r, ~ p- <br /> <br />OWNER'S NAME (Y),q -:) ~ )-,:C 0'/.\ rc.,J Rl v <br />JOB ADDREss3cr .'554- ~ p;t. <br /> <br />An <br /> <br />PHONE ~ qs-~ (.,'99 t <br />J-"-f /Cf7 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />Pl\RCEL I D # ';;) 4- - ;;:> (" - €}-/-oCJ OO~ Go) O(j <br /> <br />oo'1c {OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />, I <br />WOR~ PROPSED: ~ CONSTRUCTION <br /> <br />DSIGN <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />[] 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 <br />COMMERCIAL: <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 />SET ENERGY FORMS. <br /> <br /> <br /> <br />o BUILDING <br /> <br />$ /'C; CYJ '" e> c... <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 />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />DROOFING <br /> <br />[] SPECIALTY <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />[] 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 />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 />OTHERg5L..../~ ['h~ COMPANy~.z...~/1o (?c7h~e. <br />f'~ /'--::> ~.1 <br />SIGNATURE /... ,..- ~ ,/ru:" (-~ <br /> <br />STATE CERT OR REGIST <br /> <br />.- <br /> <br />#. 2-'#~)- <br />J-..,I-~ <br />