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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />Lu, new- 4/Y/:5. LA1~ <br />7t,/3 AercJvU'rlJ/IIIL ur~ <br />J,-~ BLOCK / <br />. <br /> <br />--35 ... ~ S- "'d.J . () /,;1..0 -ODOOO -018 D <br /> <br />PHONE 813 - CZ g2- - J-/-h63 j}3 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />SUBDIVISION 6u..l-f1/~ <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: agNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: riI SGL 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 />BUILDING SIZE <br /> <br />D <br />UI..o S& <br />-3 gig" ox 06 I <br />. <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />UCZb1U ~~ 0o/L)~ 1;- <br /> <br />SQUARE FO TAGE dl30Lj <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF WORK <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 />o BUILDING <br /> <br />$ <br /> <br />PERMITS REQUESTED <br />J~7; 0Cb. D..Q. VAL~ATION OF TOTAL CONSTRUCTION <br />AMP SERVICE 0 Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o ELECTRICAL <br /> <br />o PLUMBING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />'-', ^ /'oA. e.. <br />~L/~ VALUATION OF MECHANCIAL INSTALLATION <br />o SPECIALTY 0 OTHER <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />TYPE OF CONSTRUCTION: if BLOCK 0 FRAME <br />FINISHED FLOOR ELEVATIONS 1;1. 7. 5"b / <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />o NO <br /> <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />5 <br />CI3C o1&&9i <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />********************************************************* <br /> <br />SIGNATURE <br /> <br />x: Il- <br /> <br />/.. ~cU^, 111 <br /> <br />COMPANY [}I /y>O/J.... ~ <br />STATE CERT OR REGIST # 00/3/.3 'f <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />~}t <br /> <br />~j/~ <br /> <br />COMPANY ~+ <br />STATE CERT OR REGIST # CF~L/d 99 f <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />* ** ** *** ** * ** * ** * **** * * ** * ** * * ** *** ** * ** **:;e.* * ***.~ * ** * * * *** *** <br /> <br />~ ~ COMPANY. L~ #~Al fl~ <br />fit . '(l,{,(l-tt/ STATE CERT OR REGIST # Ci4CLJSo 4/0 <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />· ...;; ... .... '('1'" ........ ... ...::~::;:. C"'Y;;;Z;,;;' H~ <br /> <br />C/)/I)< p.J)~ STATE CERT OR REGIST # 1lc:.J./ ~- () /3 <br /> <br />OTHER <br />