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<br />I I <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aTR Bt, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />~ )Q; r~ ~-ko.~ <br /> <br />JOB ADDRESB~~' S ~'" K- :D,- <br /> <br />OWNER'S NAME <br />, ' <br /> <br />PHONE 177 - 7 Di / <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL ID It -.Jd--d.(,~al .. 00'30 - ootooo "" OJd-O <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEI <br /> <br />WORK PROPSED: (JNEW CONSTRUCTION (J ADDITION (JALTERATION (J REPAIR (J INSTALL <br /> (JSIGN ' (] MOVE 0 DEMOLISH <br />PROPOSED USE: [JSGL FAMILY DWELLING [JMULTI-FAMILY [J1t OF UNITS (J MOBILE HOME <br /> (J COMMERCIAL o INDUSTRIAL (J SWIMMING POOL (JOTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />CJ RESTAURANT '. HEALTH DEPARTME'f APPROVAL <br /> <br />\~ Y'J '4 f1b~ /U...'U)O~ <br /> <br />SQUARE FOOTAGE <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 FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />(J BUILDING <br /> <br />$--=1.~S~. oD <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[] ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[J FLORIDA POWER <br /> <br />[J W.R.E.C. <br /> <br />(J, PLUMBING <br />! [J' MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />(J GAS ,,0 ROOFING ,: (J SPECIALTY <br /> <br />TYPE OF, CONSTRUCTION: 0 BLOCK <br /> <br />(J FRAME <br /> <br />o STEEL <br /> <br />(] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />I S PROJECT IN FLOOD ZONE AREA[J YES [J NO <br /> <br /> <br />SIGNATURE <br /> <br /> <br />CONTRACTbR:~lS~C'lfON <br />\. ," .~~:::~ ;.., i.. '.i,'~l;'.....: ..' .;.:.., .I)l ,:....~~ ."...'. .,~,'i. _". '''''''." ..'._ ". - ..!".-..... ._, <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br />STATE CERT OR REGIST It c...cc. 'D 58134 <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST It <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST It <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT <br /> <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST It <br />