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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aD St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />1--~~05 <br /> <br />OWNER'S NAME 't'A..o; \.I.Q.II'\. Yl'\~ r ~ 0 '" <br />J 'J . <br /> <br />JOB ADDRESS 39 S~4 ~OUJ()CJot l ootp <br /> <br />PHONE CONTACT FOR PERMITTING <br />'I ~3 "OJ I L( ('-'-) <br />PHONE 1/ ~. fob;}~ (W) <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL 10 # 13.~.~I~DIY.O ..000004 (:l.'\D <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />. [JSIGN <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE} <br /> <br />[J ADDITION <br />, [J MOVE <br /> <br />[J ALTERAT ION <br />[J DEMOLISH <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />PROPOSED USE:OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />[J OTHER <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK d l t .sh.~ 1U.-^-O/)6 <br />BUILDING SIZE SQUARE FOOTAGE <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 />o BUILDING <br /> <br />$ <br /> <br />~ f \ lie S.9Ji!- <br /> <br />PERMITS, REQUESTED <br /> <br />1 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />[J, PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[J OTHER <br /> <br />OGAS <br /> <br />o ROOFING [J SPECIALTY <br /> <br />TYPE OF, CONSTRUCTION: 0 BLOCK <br /> <br />[J FRAME <br /> <br />[J STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES [J NO <br /> <br />SIGNATURE <br /> <br />c()NTRACT6R~SI:CTION .. '. .. . ' <br />'",'"::';",.:;",,,,,",."';';;""" .::~:?~ -'sd-pr ~""":.J,.J~. <br /> <br />(~~ . STATS cSRT OR REGIST * CJ:. C I) 'S'(I .1.,-/ <br /> <br /> <br />***************************************************************** <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST It <br /> <br />****************************************************************** <br /> <br />PLUHBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST It <br />