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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aTH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />ff-5-QS <br /> <br />OWNER'S NAME <br />, ' <br /> <br />r- \f)h~ <br />39LJ4l <br /> <br />C;r"<~{ a... <br />~o->tJOO:J Loop <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />JOB ADDRESS <br /> <br />PHONE '~, J,.? g ~. lo;J. 3~ <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL 10 f# 13.d.L ..~\ . 0/4D. oor:Do "D 39 D <br /> <br />SUBDIVISION <br />(ORTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />[JSIGN <br /> <br />o ADDITION <br />, 0 MOVE <br /> <br />o AL TE RAT ION <br />o DEMOLISH <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />PROPOSED USE: (]SGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />(]MULTI-FAMILY <br />o INDUSTRIAL <br /> <br />(]f# OF UNITS <br />[JSWIMMING POOL <br /> <br />[J MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />all V3 df' ~h~~ /LL -/\..0 D J <br />o <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />o BUILDING <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. / / l 1q rt <br /> <br /> <br />REQUESTED (1 ~ <br /> <br />VALUATION OF TOTAL CONSTRU~ <br /> <br />PERMITS <br />r' <br /> <br />$ 5.icrl./-S <br /> <br /> <br />(] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o W.R.E.C. <br /> <br />0, PLUMBING <br />,} (]' MECHANICAL ' <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />[J OTHER <br /> <br />o GAS ,0 ROOFING I' [J SPECIALTY <br /> <br />TYPE OF,CONSTRUCTION: 0 BLOCK <br /> <br />[J FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE MEAD YES 0 NO <br /> <br />I", <br /> <br />BUILDER <br /> <br />C~!t'Ox(~ar;:c~t(>>:f ~ <br />J ,... '""""""C:P:~ 3cl-.:,- ~ ~.A 'Q. ~. <br />9::. 1/.. ..~!:!:::.......... ~~~~~. ~~~~. ~~. ~~~:~~.:...:~ ~..D stf /3'1 <br /> <br />1 <br /> <br />SIGNATURE <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST f# <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST f# <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST f# <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST f# <br />