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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 />... <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />LLnnar Y-b1'i/:5, LM6 <br />JOB ADDRESS~Drr fY1CtoJuud-vdk urclJ <br /> <br />PHONE 813 - ;;?g2 - J-j&63jJ3 <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRI PTION: LOT (S) ~ .;L- <br /> <br />BLOCK - <br /> <br />SUBDIVISION Ou..l.fl/ilvJ <br /> <br />PARCEL 10 # '0 "S - ~5""' ~ J - O)::uJ ~ r)('X)co - () ) ~ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: rilSGL 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 />lSI_ 0 S& <br />'-10 X ~;l' <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />UCZi:')(!] , rLJ/ ).( ,fLUlS- <br />SQUARE FO TAGE ~~01- <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 />PERMITS REQUESTED <br />)~,L)Ol).O~ VALUATION OF TOTAL CONSTRUCTION <br />, <br /> <br />$ <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 />0/, 000, d..2 <br /> <br />, <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION: g"BLOCK <br /> <br />o OTHER <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />/:l7. 50 ' <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br /> <br />STATE CERT OR REGIST # <br /> <br />:5 <br />aC tJ;j~&9J <br /> <br />SIGNATURE <br /> <br />~ <br /> <br /> <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />Or)( <br /> <br />wtWpdp <br /> <br />COMPANY &I fY)(]Jl Y:h<-- <br />STATE CERT OR REGIST # 00/3/3 'f <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />k <br /> <br />{\ 'I <br />rv~ <br /> <br />COMPANY ~-I- , <br />STATE CERT OR REGIST # CFGOL/~ 99? <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />* * * * * * * * * * * * * * * * *.* * * * * * * * * * * * * * * * * * * * * * * * * * * *It. * * * * *.*f * * * * * * * * * * * * * <br /> <br />/:, ""\ COMPANY -1[. Q ~rzIlI~jA1 {J-f9u . <br />jI.JAA. R0t1/~ STATE CERT OR REGIST # C.A('.LJ50 4/0 <br /> <br />· ...;;~. ..... ~/;;;;;"'" .~:~::~: 'c' '~'i:ni:;~j <br /> <br />j{---t ~ {/' ~ STATE CERT OR REGIST # . 6 f:,-O / <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />OTHER <br />