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<br />I r <br /> <br />CITY OF ZEPHYRnILLS 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 />PHONE CONTACT FOR PERMITTING "'9' - \ .11 <br /> <br />JOB ADDRESS <br /> <br />510<'::' <br /> <br />1\"". ~-\ <br /> <br />"'2. ~~1'{ ~'"\ \\ S <br /> <br />PHONE "8 Vs -~~, - \'") II <br />~\ <br /> <br />OWNER'S NAME Cc::...... \ ~-o"'(-(l.,....... ~~"'$~JlrQ... <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # "-'L~-'-"-O"O\U!-\~z.:O~- ()''\~ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />i81 REPAIR <br /> <br />o INSTALL <br /> <br />OSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />! <br />PROPOSED USE:~SGL FAMILY DW~LLING <br />o COMMERCIAL <br /> <br />OMULTI - FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />""~'m QL ~ <::"_Cl..(\,Q., \ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />%SotF <br /> <br />I <br />HEIGHT J 2... <br /> <br />RESIDENTIAL: ATTACH (2) PLOT!PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETSioF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SET$ OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY'REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br /> PERMITS REQUESTED <br />-jZJ BUILDING $ &0 <::>0 (;) VALUATION OF TOTAL CONSTRUCTION <br />) <br />Q, ELECTRICAL I SO AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br />~ PLUMBING (j <br />.Q MECHANICAL $ ~()OO VALUATION OF MECHANCIAL INSTALLATI04t 4 ~ ~ <br />o GAS o ROOFING o SPECIALTY 0 <br /> OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />-g FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES ~ NO <br /> <br /> <br />SIGNATURE <br /> <br />~9 <br /> <br />COMPANY ~""'AI.. Cr'V-\.\ <br /> <br />1:. k (.. <br /> <br />BUILDER <br /> <br />~Q..~ <br /> <br />STATE CERT OR REGIST # CiCC. 05 ~ cLs3 <br />~ LAC- . <br /> <br />******************************************~~~~************** <br /> <br /> <br />ELECTRICIAN 1\_ COMPANY-~ tf e.' . <br />SIGNATURE ~ ~ ~ STATE CERT OR REGIST # bU:.V~Df) 1"'~<3 <br /> <br />****************************************************************** <br /> <br />PL~R ~ rl <br />SIGNATURE , ' ~, ~ ~, <br /> <br />COMPANY jVt (->{ P fit. U M b) ,IJ <br />STATE CERT OR REGIST # C~?>3'B C;;3 <br /> <br /> <br />SIGNATURE <br /> <br />**************** ************** <br /> <br />OTHER <br /> <br />COMPAN <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST <br /> <br />'- <br />