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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8D St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IWD <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />~R'S NAME Gl~~~" <br />JOB ADDRESS Y)l!.D ~ I oo:J:,e rr~ I "Of <br />LEGAL DESCRIPTION: LOT(S) , BLOCK <br /> <br />PHONE ~l ~'J)'? '.D030 <br /> <br />PARCEL 10 ## <br /> <br />10 ~ d C,," 61 ~ 01 dlJ 'iQ1)Q()r) .. ()O f...O <br /> <br />SUBDIVISION <br />(ORTAIN FROM <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />[J SIGN <br /> <br />PROPERTY TAX NOTICEl <br /> <br />[J ADDITION <br />. [J MOVE <br /> <br />[JALTERATION <br />[J DEMOLISH <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />o OTHER <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK o'?t{ aGj. Jd k?JU ,A..I. - A Or <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 />[J BUILDING <br />o ELECTRICAL <br /> <br />.- <br /> <br />~ OV <br />$ ,,1 (}-;}. <br /> <br />l?:&:RMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />[J W .R.E .c. <br /> <br />O. PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />[J GAS ..0 ROOFING 0 SPECIALTY <br /> <br />TYPE OF. CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES 0 NO <br /> <br />L <br /> <br />BUILDER <br /> <br />~9~!J;.Q~f~,~~~!l'J.~. I <br />() COHPl\Ni-u1J.<:,~~~.~, <br /> <br />~~ STATE CERT OR REGIST # Cc-L OSi?/31 <br />....::.:........................................................ - ,- <br /> <br />SIGNATURE <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 />