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<br />I I! <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aT. St, Zephyrhills, FL 33542 <br />913-790-0020 FAX: 913-790-0021 <br /> <br />DATE RECE lVED <br /> <br />O~ER' S, NAME t"o <)~b; <br />JOB ADDRESS ::> 8 '5 31) <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />f(!'VII,k.) u;r;:~:7- PHONE l8~.'10J.~ <br />S~ ~AAI(J , <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL 10 f# .Ji.::dJJ.. t311 - DOl ~ . 0 I <O~D C" DOl D <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />[J SIGN <br /> <br />(ORTAIN FROM PROPF.RTY TAX NOTICEI <br /> <br />[J ADDITION <br /> <br />DALTERATION <br />[J DEMOLISH <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />, 0 MOVE <br /> <br />,PROPOSED USE: []SGL FAMILY DW~LLING <br />[] COMMERCIAL <br /> <br />[]MULTI-FAMILY <br />[] INDUSTRIAL <br /> <br />Off OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />[JOTHER <br /> <br />BUILDING SIZE <br /> <br />o RElSTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />a-a.. ~ ::I:'JS ;thO! ..<:~ ~ <br /> <br />SQUARE FOOTAGE <br /> <br />DESCRIPTION OF WORK <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ,ATTACH (2) PLOTIRLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETSiOF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETfOF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY,REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />o BUILDING <br /> <br />i <br />(;) O!b <br />$ ':> , -,I~. i <br />i <br />: AMP <br /> <br />}?E,RMITS REQUESTED <br /> <br />o ELECTRICAL <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />0, PLUMBING <br />" 0' MECHANICAL ' <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />[J GAS ,,0 ROOFING ,,0 SPECIALT~ <br /> <br />TYPE OF, CONSTRUCTION: 0 BLOCK <br /> <br />[J 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 />SIGNATURE <br /> <br /> <br />C6N'l'RACTOI(~is:gC']f()N <br />'.;~., '#-.':L :.." i., '.L;.,......: ..-:';l,;:,jo.IJ .'.......} ."...;'h' '". . ~ .; '.' ,',' ..l:~... __. <br /> <br />COMPANY <br /> <br /> <br />u.' ~c.~~~~.~. <br />OR REGIST f# Cc.c. 0 Sfl/3 Y <br /> <br />BUILDER <br /> <br />STATE CERT <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST f# <br /> <br />*****************1**********************~************************* <br />i <br /> <br />SIGNATURE STATE CERT OR REGIST f# <br /> <br />*****************1************************************************ <br />MECHANICAL COMPANY <br /> <br />SIGNATURE <br /> <br />i <br /> <br />STATE CERT OR REGIST ## <br /> <br />***............*. <br /> <br />1..**.**.************************************** <br /> <br /> <br />COMPANY <br /> <br />OTHER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST f# <br />