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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 />PHONE CONTACT FOR <br /> <br /> <br />DATE RECEI <br /> <br />OWNER'S NAME :i;; L.4u-L:> '?2 c ~ d",. -> PHONE <br />JOB ADDRESS I ~ '?J ~ C"7 ~ \ \ B \ \..) b (\M e-{t(~~~-d f::>l-,a. '.:2-..4- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br />/- <br />OALTERATION . ~ REPAIR 0 INSTALL <br /> <br />OSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />9f;MMERCIAL <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 />D RESTAURANT <br />I P ~. J2 \ 1) .2.- <br />, <br /> <br />(g P PO <br /> <br />& HEALTH DEPARTMENT APPROVAL <br />e..1!f?:-~ 0 V' A- -t I; J.-,:; <> <br />SQUARE FOOTAGE / 55 ~ <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF WORK <br /> <br />RESIDENTIAL: ATTACH (2) PLO~ PLANS & (2) SETS OF BUILDING PLANS & (1) SET <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.C ,e~~1 ,/ <br /> <br />NO JV\) qJ)- <br />V jLJ-t. U1 <br /> <br /> <br />ORMS. <br /> <br />u5 <br /> <br />~UILDING <br />~LECTRICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy <br /> <br />o <br /> <br /> <br />\ <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 />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # t: )3C-! d 1) tJ6-':!J.3 <br /> <br />******************************************* <br /> <br />COMPANY <br /> <br />'vv' .Art... ti. e c- J <br /> <br />OR REGIST # <br /> <br />PL"')}"'d:.,~ ~. <br />SrGm;. G ' 12 6r-L. <br /> <br />COMPANY (I f<<-~ ~ ~" <br />STATE CERT OR REGIST # eF=e I flz. g y/tJ< <br /> <br />MECHANICAL <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />I <br /> <br />* * * * * * * * * * * * * * * *1* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />