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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 4"'" /.:2 - zx;- <br />, <br /> <br />PHONE CONTACT FOR PERMITTING 5;<)- ~9{ 1 <br /> <br />PHONE ( Z I~) g3&' -I h53 <br /> <br />, <br /> <br />OWNER'S NAME <br /> <br />~l' vn A I bMLt~~ <br />0505 U1MJjn3-1-m <br /> <br />Dr <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # ~l~~b-;)'I-OI10-0000()-OggO <br /> <br />WORK PROPSED: oNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br />~LTERATION 0 REPAIR 0 INSTALL <br />o DEMOLISH <br /> <br />o SIGN <br />PROPOSED USE: 0 SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <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 />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH <br /> <br />~ff {)uX, <br /> <br />DEPARTMENT APPROVAL <br /> <br />41e- SJ~rf~ I <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 />o BUILDING <br /> <br />$ <br /> <br />& (1) SET ENERGY FORMS. <br /> <br />FORM~ <br />(~ <br />PERMITS REQUESTED "(/ 17/0 I <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br /> <br />o ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br />~LUMBING <br />MECHANICAL $ {o0:J5.0'O VALUATION OF MECHANCIAL INSTALLA'rION <br />o GAS o ROOFING o SPECIALTY 0 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 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 REG 1ST # <br /> <br />SIGNATURE <br /> <br />*******************************************~!*7***2'..~........~ <br /> <br />COMPANY 1$ It c.. CJ)VUfd;r\ <br />~ ~ STATE CERT OR REGIST * CJjC-05 515 <br /> <br /> <br />****************~************************************************ <br /> <br />MECHANICAL <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />