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<br />CITY OF ZEPHYRHILLS PERMIT APPLICAT~U~ <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:813-780-0021 <br /> <br />DATE RECEIVED <br />PHONE CONTACT FOR PERMITTING tfc;J-, ~ p- <br /> <br />OWNER'S NAME {Y),q 'T' e.' ~-, :<-.. <br /> <br />~ <br /> <br />J/S/ <br /> <br />(lA- K,J it' () <br />flt ~ /?Je:I. IJ1 <br /> <br />PHONE ~ qS"~ (,,"'99 ~ <br />)t>( d+B <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />Pl1RCEL ID # <br /> <br />~4 -;;>~ - t9-J-oooo'~ GO)O" <br /> <br />00 '1c (OBTAIN FROM PROPERTY TAX NOTICE I <br /> <br />i rh_~ <br />WOR~ PROPSED: ~EW 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: 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 />COMMERCIAL: 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 />$ /'<::;CO" e c-., <br /> <br />VALUATION OF <br /> <br /> <br />SENERGY FORMS. <br /> <br />PERMITS REQUESTED <br /> <br />f'1/1/~ <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy [] <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 <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 It <br /> <br />***************************************************************** <br /> <br />OTHERg5L..../~ ~i,j..,~ COMPANY~.5C""//O t0C7hou::::e.e- <br />r ,~ /.----::> ~~ <br />SIGNATURE /..... ) ~ ,/C'.,. (-~ <br /> <br />STATE CERT OR REGIST <br /> <br />.- <br /> <br />#_ 2-,/f~) <br />~/'~ <br />