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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 />DATE RECE lVED <br /> <br />g-S-D::S- <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />1/ 1/ <br />OWNER'S NAME .5l?r'Hr/1 (!;c.:.'rrIJ <br />, <br /> <br />h ;</11..~ to' te <br />LEGAL DESCRIPTION: LOT(S) ~~~~(, <br /> <br />JOB ADDRESS <br /> <br />a"tt( <br /> <br />/1/7- ve~.4p r <br />j).~. <br /> <br />PHONE <br /> <br />7&'~ - ~:J..Yo <br />. <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />s; Iv t' /' (J /-!-- /C ~ <br /> <br />PARCEL 10 # t:3 -, Jrb' 21- (.V.Jo '{i'bt1tJ,,1 -os~o <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />A REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED <br /> <br />DSIGN <br />USE:~SGL FAMILY <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DWELLING <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 />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />tI> kCi, trII -t- l-e ~ (~i /'~S' (" chh C' ~:- <br /> <br />.'3~o <br /> <br />3CJfr ;;:/;~~/-C-J <br /> <br />, <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <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 />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br /> <br />1169 <br /> <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />6,000 <br />, <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br /> <br /> <br />o MECHANICAL $ <br /> <br /> <br />o GAS jiROOFING 0 SPECIALTY <br /> <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o OTHER <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 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <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 REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # ~ I~ <br />", Ii':;; () <br />***********************************************************~ ~ ~ <br /> <br />OTHER /?~t'~/ A.J(7 COMPANY 'MII'U- {kc(,J,1,1 I?ctJ'~fJ(,l<t /N'(- . <br /> <br />SIGNATUR~ ?( ?fJ?/ <br /> <br />STATE CERT OR REGIST # a:.l:.DC(Q37D <br />