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<br />I I <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542 ~ A <br />813-780-0020 FAX: 813-780-0021 q /3 V c; <br />DATE ~CE IVED f (, - <br /> <br />PHONE CONTACT FOR PERMI~G 9:f52:-L/51-[i6'1:-0 <br /> <br />OWNER'S NAME R-6nc)::::> ~mCVln <br /> <br />JOB ADDRESS~4~}\1.lO. <br /> <br />~d1I1L~ <br /> <br />BLOCK 'I....... <br /> <br />PHONE Y;2:-4S~?;1S <br />FL ~~9fZ- <br /> <br />LEGAL DESCRIPTION: LOT(S) <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 />o ALTERAT ION <br /> <br />o REPAIR <br /> <br />ltf 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 />o MOBILE HOME <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br /> <br />SQUARE FOOTAGE ~~ a <br /> <br />HEIGHT <br /> <br />RESTAURANT <br /> <br />DESCRIPTION OF WORK <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 GAS <br /> <br />o ROOFING <br /> <br /> AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br />$ VALUATION OF MECHANCIAL INSTALLATIO~ ~{\?- \0 <br />o SPECIALTY 0 OTHER <br /> <br />o ELECTRICAL <br /> <br />o PLUMBING <br />o MECHANICAL <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 />\ <br /> <br />IS PROJECT IN FLOOD ZONE AREAo YES ~ NO <br /> <br /> <br />SIGNATURi~ <br /> <br />.~. <br /> <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLtMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECtiAN I CAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************~************************************************ <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />