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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8ft St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IWD <br /> <br />7- .,;;, 7- iJ 5- <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />~R' s. NllME ~~, ~"Y'\ <br /> <br />JOB ADDRESS_(() d \ ~ I q~ .3tu..d <br /> <br />PHONE <br /> <br />'l~d-.'19~~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # Cd~~(,"d'- O\9'D. 00000 ~ od<=1D <br /> <br />(ORTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />. [JSIGN <br /> <br />[J ADDITION <br />. 0 MOVE <br /> <br />[JALTERATION <br />[J DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />[JMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />[J MOBILE HOME <br />[J OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />\~ i Q~ M-AI11 <br /> <br />SQUARE FOOTAGE <br /> <br />BUILDING SIZE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />o BUILDING <br />[] ELECTRICAL <br /> <br />$ ~ l.o d-.<.o. DO <br /> <br />PERMITS REQUESTED <br /> <br />// <br />( q11D <br /> <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />[] W.R.E.C. <br /> <br />0, PLUMBING <br />[] MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[J OTHER <br /> <br />[] GAS[] ROOFING [] SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />[] FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />SIGNATURE <br /> <br /> <br />; ......:- .'.' : , , '.',' -q . .- < - ';~~.'.;. ''-'0' . <br />CO~C!l'OR~~'SBCT:tON <br />!.; ~_.'~,.::L ;,,' : .'_ . ',i .'.;':.-::, .... '_'''_;';'~ ...olJ); ,";."6~' ".... '#";:.{.. ". ".:,:~. .'_ ,,',. ,_ _,,!'.:.... >. <br /> <br />COMPANY ~ <br /> <br />STATE CERT OR REGIST # C c.c... <br /> <br /> <br />BUILDER <br /> <br />**************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGISTIt <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 # <br />