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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 /> <br />OWNER'S NAME <br /> <br />[u,/lar <br /> <br />WORK PROPSED: [g NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING '7>. 13.- q){. 2f31 <br />,,)J tu" L \ 0bl- <br />PHONE g!3 - rggz.- 4iPd\31133, <br /> <br />SUBDIVISION ws-l-vlwJ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <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 />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK L5t ot Il JrJtJ{I~~ 0JJ/ ).;:.C& /1+-- <br />BUILDING SIZE Lcf) d f. ~ SQUARE FO TAGE C)3, y- J <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 />PERMITS REQUESTED <br />$ {2JJ'f; ~ VALUAl'roN 0'- TUTAL CONSTRUCTION <br />80 AMP SERVICE 0 Progress Energy ~ <br /> <br />~UILDING <br />ri:{kLECTRICAL <br />~LUMBING <br />~MECHANICAL $ <br />o GAS ti)OOFING <br /> <br />t-} , QCD, - <br /> <br />, <br /> <br />W.R.E.C, <br /> <br />o OT HER <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br /> <br />o SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ~BLOCK <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />(dLOO <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~ <br /> <br />COMPANY <br /> <br />****~**********************************.************** <br /> <br />STATE CERT OR REGIST # <br /> <br />ELECTRlCIAN <br /> <br />~.~ <br /> <br />~1lI <br /> <br />SIGNATURE <br /> <br />COMPANY [}f/()O/7,Y;:J-t"L.- <br />STA~E CERT OR REGIST # ()() /3 jj i <br /> <br />****************************************************************** <br /> <br />******************************************~****~~************ <br /> <br />f/ ill COMPANY. L~ ~lt:{l J:1~ <br />~ tljLe~ STATE CERT OR REGIST # C/4C[)S';? A/I D <br /> <br />PLUMBER <br /> <br />p~~ <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />COMPANY IYl1()'K..R.-- + <br />STATE CERT OR REGIST # CFc,{J'IJ. S7(J ~>' <br /> <br />OTHER <br /> <br />L lDM~ <br /> <br />***************************************************************** <br /> <br /> <br />COMPANY C. 01m!Ult;- :tt:Zr- <br />U A : /J - ~ /- . ( <br />STATE CER'f OR REGIST # '110, S :I (!,) /3 <br /> <br />SIGNATURE <br />