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<br />w' <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICAT~UN <br />BUILDING DEPARTMENT 5335 8TH St, Zaphyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br />PHONE CONTACT FOR PERMITTING ic.;J-'. ~99 ~ <br /> <br />JOB ADDRESS <br /> <br />.' '3 7 1:) <br /> <br />Jj/tiG~ <br /> <br />(lA K,J itl c <br />{2;.(f4...",flJ,{ <br /> <br />fi2A. <br /> <br />PHONE (,qS.-C,998" <br />)or o>SI <br />. <br /> <br />OWNER'S NAME (Y),q "T' ~ ~-,:<.. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br />oo9c (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />Pl\RCEL 10 # ~4 -;;)(" - cS-/-OOOD~ colao <br /> <br />t I <br />WOR~ PROPSED: ~ CONSTRUCTION <br /> <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 <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 />& (1) SET ,ENERGY FORMS. <br />FORMS. <br /> <br /> <br />1-{111 <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ /'t:;CX) " C'J 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 />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-..../~ ~J:,J.,.,~ COMPANV#C?.zy"#O (?c7h~ <br />~ e---? ~ <br />SIGNATURE J _ A -:.. (- <br />, <br /> <br />STATE CERT OR REGIST # <br /> <br />.- <br /> <br />2-oII~) <br />~/-~ <br />