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<br />I I <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8~ St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />1/t/-s <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME ,Rn^a.....tol <br />JOB ADDRESS 5 f) 4 q <br />. <br /> <br />U. <br />\ \ ~-\" <br /> <br />UQ..flrle.r'\. h e..e-f\ <br />21:",of! 'I R l.J: 115 <br /> <br />PHONE <br /> <br />~/. <br /> <br />7j3~Lfd . <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # II t!J6 ;;JI 0010 I~/OO 00 30 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />[iJ"'REPAIR <br /> <br />ffl'NSTALL <br /> <br />o SIGN <br />PROPOSED USE: ~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <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 /> L~t/vk5 ) <br /> / <br />HEIGHT 010 <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />SQUARE FOOTAGE 8'00 -1' r:-r-: <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) SET$ OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />BUILDING SIZE <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br />MLECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />;;200 <br /> <br />AMP SERVICE <br /> <br />~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 />OYfRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAo YES ~ <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />ELECTRIC~~~ <br />SIGNATURE :.:...... ~ <br />?, <br />****************************************************************** <br /> <br />****************************************************************** <br /> <br />!~ (JV-1~ <br />I <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />i <br />*****************~*********************************************** <br /> <br />OTHER lo~~-c.ev< .COMPANY <br />SIGNATURE . : . STATE CERT <br /> <br />OR REGIST # <br />