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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 IVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />eA <br />(3')3) Q'f'9- S3 Y'7 <br /> <br />OWNER'S NAME BKftl/tR fJ/(OPFIfJIrBS'(J'/!/C.r <br />JOB ADDRESS Y9ttJ9 ~f~ Sr,Y~~~ <br /> <br />PHONE <br /> <br />.... <br />, <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: []NEW CONSTRUCTION <br /> <br />[] ADDITION <br /> <br />[]ALTERATION <br /> <br />[] REPAIR <br /> <br />[] INSTALL <br /> <br />[]SIGN <br /> <br />[] MOVE <br /> <br />[] DEMOLISH <br /> <br />PROPOSED USE: [] SGL FAMILY DWELLING <br />[] COMMERCIAL <br /> <br />[]MULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />[]# OF UNITS <br />[] SWIMMING POOL <br /> <br />[] MOBILE HOME <br />[] OTHER <br /> <br />BUILDING SIZE <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />50 ... I'~ /1/<<;;:: r(.G? C' ~ <br />S ARE FOOTAGE <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF WORK <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 />PERMITS REQUESTED <br /> <br />[] BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[] Progress Energy [] <br /> <br />W.R.E.C. <br /> <br />[] PLUMBING <br />[] MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] GAS <br /> <br />[] ROOFING <br /> <br />[] SPECIALTY <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: [] BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />[] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES <br /> <br />[] NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY ,4 ~Ac/l' /'BL C ~//JI'7f=r.<:7l.ll41 Jlt. <br /> <br />STATE CERT OR REGIST # C ;$C()(;o;:;9<f <br /> <br />****************************************************************** <br /> <br />ELEC <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 # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />