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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 RECEIVED <br /> <br />~7ft' <br /> <br />, <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME 0nJJ1tl <br />JOB ADDRESS ~ 76-1::/ <br /> <br />HO(tZOi'1 <br />C'I/ Av~ <br /> <br />PHONE <br /> <br />Loi 27P <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 />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />~ILE HOME <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br />MH <br />27 x5 ) <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APrROVAL <br /> <br />AJot f <br /> <br />~CRIPTION OF WORK <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 LL"O.. "vSHAL . ' <br />. . .' ~v 1'0....... L C01\.1PL Y WITH ALL <br />'~V AlllNGCODES, fl.ORIDA BUILDING <br />...~DE. NATIONAL ELECI'RlCOODEANr <br />'~ITY OF ZEP1NI;' "-:f(' 0RT)INA NCF'" <br /> <br /><;6/ t: "Z (~ ;,- <br /> <br />(';A) <br />W.R.E.C. <br /> <br />PERMITS REQUES~D <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy <br /> <br />o <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <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 0 NO <br /> <br />. <br />,y <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SrGNATURE~~, ~~~~~> S'IATE CERT ORREGrST I <br />****************************************************************** <br />COMPANY Act- <br /> <br />ELECTRICIAN <br /> <br />SrGNATURE~'~- )<..._-~-#e,j' <br /> <br />STATE CERT OR REGIST # <br /> <br />PLUMBER <br /> <br />****************************************************************** <br /> <br /> <br />COMPANY & -t-f-eJdI~ <br /> <br />SIGNATURE <br /> <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />* * * * * * * ** * *** * * * * * * * * * J+.Z. * * * * ** * * **.~ * ** * * * **.* <br />COMPANY L <br /> <br />SIGNATURE ~ ~ ~_ ~~r~ STATE CERTOR REGIST # <br />*~************************************************************* <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />c. <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />