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<br />I ' <br /> <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 />9f /~S <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME L(!-NtVA./Z kbM~ ( / US I-fPf./lt:. ~ PHONE <br />/ <br />JOB ADDRE S S LOT It> .:( TD'\J " .5; T~-.u.. T ZLp I-, ;U2. ~ , f ( s f=' I <br /> <br />SUBDIVISION (!e<'S7'LI,U._~ J..// I (s <br /> <br />LEGAL DESCRIPTION: LOT(S) (02' fP~ <br /> <br />BLOCK <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br />PROPOSED USE: ~SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />oMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />MC/du I.:J<A <br /> <br />R(tJ<:1:.: KLTC. 'v I w y !.rJCA... J f ( :2. ) <br />SQUARE FOOTAGE /2, V(JO s~F; <br /> <br />(t- 1- <br /> <br />~ <br />(::YS' <br /><" (r <br /> <br />BUILDING SIZE <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 ~ORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. ~'--7. )-..:.:> !;)J))~, <br />JL. I?'- <br />1r~ <br />PERMITS REQUESTED t.; 7 7 ~ 31/1 <br /> <br />0 BUILDING $ Z'-f 1, ()t?'O VALUATION OF TOTAL CONSTRUCTION <br />0 ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br />0 PLUMBING k~~O?- <br />0 MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION <br />0 o ROOFING o SPECIALTY 0 <br />GAS OTHER <br /> <br />TYPE OF CONSTRUCTION: ~ 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 AREAo 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 # <br /> <br />. ****************~*******.***************************************;**\ <br />(~J3) q7_1-Ll'-l~~ i 7""{)dvcr~ (l.....r1--:l-'" F~I~...J <br />J // .0 d /1 ;e/ 5.~'r1LII"N ?rtJdvt-G <br />OTHER ./9<;"st>c-/o...r~c C.:.o,yf'-r-e,,h..T''''N COMPANY rYSS/J..It:>..T"fi'. , CO' ' <br /> <br />SIGNATURE ~ ~.-j STATE CERT OR REGIST # 611:>z2U, O€.r' (Qu<-.!' r;'l/r; <br />C<.wr'-"'c.t.- 1=-1111." CaL \'2.5'0373- <br />