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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 RECE lVED <br /> <br />7- ;/7" 05- <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br />" ' <br /> <br />O.f'\--{~~ / G-<orr<- JAOr'h~U.Y'~ <br />, 1 <br />loOd-3 - bOd' 't-tl( ...stAU:::t <br /> <br />PHONE <br /> <br />)"8 J -I 5'4 I <br /> <br />-!OB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # O;;'~a..c..,-~I-O/(t1n. (00\OD~t)tOO <br /> <br />WORK PROPSED: (JNEW CONSTRUCTION <br />. DSIGN <br /> <br />{ORTAIN FROM PROPERTY TAX NOTICEl <br /> <br />D ADDITION <br />, D MOVE <br /> <br />(JALTERATION <br />(J DEMOLISH <br /> <br />(JREPAIR <br /> <br />(J INSTALL <br /> <br />PROPOSED USE:~SGL FAMILY DWELLING <br />(JCOMMERCIAL <br /> <br />(JMULTI-FAMILY <br />(J INDUSTRIAL <br /> <br />(J# OF UNITS <br />(J SWIMMING POOL <br /> <br />(J MOBILE HOME <br />(JOTHER <br /> <br />I:7 RESTAURANT · ,HEALTH DEPART APPROVAL <br />DESCRIPTION OF WORK ,;/5 Y, , S~J A-t '.. n l <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 />VALUATION OF TOTAL CONSTRUCTION <br /> <br /> <br />(J BUILDING <br />(J ELECTRICAL <br /> <br />~ 00 <br />$ , lo3D, <br /> <br />PERMITS REQUESTED <br /> <br />AMP SERVICE <br /> <br />(J FLORIDA POWER <br /> <br />(J W.R.E.C. <br /> <br />0, PLUMBING <br />'0 MEC~ICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />D OTHER <br /> <br />o GAS ,0 ROOFING (J SPECIALTY <br /> <br />TYPE OF, CONSTRUCTION: 0 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 (] NO <br /> <br />C~TOR:~fSE'CT:t()1i <br />BUIIJ>ER ,.,- . """""-::P~~ # . \ ~A:IJ'; lat/Q. ~. <br />SIGNATURE~lh IO~ STATE CERT OR REGIST # CCc n:i1?/J;I <br />7J <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 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 # <br />