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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 />Lu,()ar 1f:;1tI~, LM6 <br />JOB ADDRESS~P(du:u1f-~II/.e Clr~e. <br /> <br />PHONE 813 - gg2 - .tf&63 j13 <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT(S) ~ BLOCK <br />PARCEL 10 # 3S..Q7'51061f"O\;u)1'YtiX)-()140 <br /> <br />- <br /> <br />SUBDIVISION W..l-l--viuAJ <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: ~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 />CJ <br />0~OS& <br />t,fd X' ~O' :2.. If <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />UczP1U~, wJ/)<f~ <br /> <br />SQUARE FO TAGE d 31 tf <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 />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />J~O/S-OD.~ <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 />J 1 (j)().~ <br />~\ <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: if 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 />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />:5 <br />Ci3c 01 &&9j <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />******************************************************* <br /> <br />SIGNATURE <br /> <br />~, <br /> <br />J)t14<d1 <br /> <br />COMPANY &J /Y1fJA ~ <br />STATE CERT OR REGIST # 00/3/3 'f <br /> <br />ELECTRICIAN <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />~~ <br /> <br /> <br /> <br />******************************************~*****~************ <br /> <br />~ lJ . COMPANY. ~ '\ 'l1)jAlJ(j~ <br />/" L ()L ){lLjcfU STATE CERT OR REGIST # ci4CDS/J 4/0 <br /> <br />NJtuy:rb <br /> <br />COMPANY ~+ , <br />STATE CERT OR REGIST # CFGOL/J. 99 f <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />H' .:;;........~............~.. ~~~::;:. (i"~' ;:;. H~ <br /> <br />~ ;JJIIPt/~ STATE CERT OR REGIST # IlC.l-l~-()/3 <br /> <br />OTHER <br />