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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 RECE IVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />Lu,()ar 1f:;1tI~, LM6 <br />JOB ADDRESS 1555 rrJerchtU7-fvJ/IL Ut-cu <br />LEGAL DESCRIPTION: LOT(S) Ii) BLOCK ~ <br />35 "';2~-.;;L/- O)..2..() -(){){XX)-6/DO <br /> <br />OWNER'S NAME <br /> <br />PHONE 8/3' ?5 g2- - J-j&63 ,/13 <br /> <br />SUBDIVISION Ou..l.fvif.i,J <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: I]!gNEW CONSTRUCTION D ADDITION DALTERATION D REPAIR D INSTALL <br /> D SIGN DMOVE D DEMOLISH <br />PROPOSED USE: ~SGL FAMILY DWELLING DMULTI-FAMILY D# OF UNITS D MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />D <br />DESCRIPTION OF WORK , lS/o s(; <br />4DX 59''1 " <br /> <br />BUILDING SIZE <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />Uau)U ~~ rLL ~ tt- <br /> <br />SQUARE FO TAGE ~1~ <br /> <br />HEIGHT <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 />D BUILDING <br /> <br />PERMITS REQUESTED <br />/~()J~~'~ VALUATION OF TOTAL CONSTRUCTION <br />I <br /> <br />$ <br /> <br />D ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D Progress Energy D <br /> <br />W.R.E.C. <br /> <br />D PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />Lf;rxD. ~ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION: ~BLOCK <br /> <br />o OTHER <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />1.;1.(, .00 ' <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 />C/3c oLj~&9S- <br /> <br />BUILDER <br /> <br />COMPA~Y <br /> <br />*********************************************************** <br /> <br />ELECTRICIAN).. <br />SIGNATUREdfrLbA.L?r <br /> <br />~rlh <br /> <br />COMPANY [}1,mOJ1. Y;JL <br />STATE CERT OR REGIST # 00/3/3 'f <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />,/ <br />~;~(L.~>s- ^Uz~j~ <br /> <br />COMPANY ~+ <br />STATE CERT OR REGIST # CF~tjrJ 99 f <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />*************************..*******************7f******f************* <br /> <br />~ . COMPANY 1[. Q ~TZ/lI2'Al ~(1.~. <br />~ (ndu ~ ;[)f/"Tt1lb STAT< CERT OR REGIST * CA, -DQJ "-I/O <br /> <br />· :;... ... ... .....;;....... .:..:~~:::. (i" ~'Z;;;' H~k <br /> <br />?;If; f'l.1~_ f Utlt;t.f'& STATE CERT OR REGIST * 11c./I!;" .0 /3 <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />OTHER <br />