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<br />I i <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 IVED <br /> <br />1/r;L/ ~ r- <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME (}ro/1d /~/() f / LOY) <br />JOB ADDRESS 773& fray (vJarl( Ave . Lot '2~/ <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br /> <br />PHONE <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY,TAX NOTICE) <br /> <br />WORK PROPSED: oNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />oALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: oSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />oMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />~BILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />D <br />/l~ ~ <br />27 :IS'S <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />5~* <br /> <br />~~p <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <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 />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <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 AREAo YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE b</ -/"'--)-<:. -- <;; ~ STATE CERT OR REGI ST I <br />****************************************************************** <br />COMPANY flr--{' <br />, , <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE Ucy- L~~~.> <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY l?v -r1C~c/ <br /> <br />c:t./~ /C'S,~ STATE CERT OR REGIST # _ <br /> <br />***************~::****************************************** <br />COMPANY 4c.-L <br /> <br />~":;v->-- A.-/;;s-,~ STATE CERT OR REGIST I <br /> <br />***************************************************************** <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />