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<br />I I <br /> <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 RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME -r;; j) () 1i=>, ('... "l <br />JOB ADDRESS -:;-7lf 0 ~ ~S r <br />LEGAL DESCRIPTION: LOT(S)--1 <br />PARCEL ID # I <br />WORK PROPSED: ONEW CONSTRuctION <br />o SIGN <br />PROPOSED USE, DSGL FAMILY D+LLING <br />o COMMERCIAL <br /> <br />PHONE <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />OMULTI - FAMILY <br /> <br />o DEMOLISH <br />0# OF UNITS <br /> <br />o INDUSTRIAL <br /> <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />~HER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J R STAURANT & HEALTH DEPARTMENT APPROVAL <br />LtA <br /> <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT <br />COMMERCIAL: ATTACH (3) SETS <br />IF SIGN PERMIT ONLY (2) SET <br />PROPERTY SURVEY <br /> <br />PLANS & (2) SETS OF BUILDING PLANS <br />OF BUILDING PLANS & (1) SET ENERGY <br />OF ENGINEERED PLANS REQUIRED. <br />REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />o BUILDING <br /> <br />i <br />I <br />I <br />I <br />I <br />i <br />I <br /> <br /> <br />o ROOFING 0 SPECIALT1 <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK I <br /> <br />I <br />FINISHED FLOOR ELEVATIONS I <br /> <br />PERMITS REQUESTED <br /> <br />~ 415 "7 <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />e{ PLUMBING <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o OTHER <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br /> <br />IS PROJECT IN FLOOD ZONE AREAo YES 0 NO <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************** <br /> <br />************************************************ <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # . <br /> <br />*********************************************************.k******** <br /> <br />PLUMBER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />***************** ************************************************ <br /> <br />MECHANICAL COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br /> <br />*********************************************** , <br /> <br /> <br />COMPANY\tJ~ T. tI~r '~f4.~ <br />STATE CERT OR REGIST #L.S"S'- C> SS- 8 3> <br /> <br />SIGNATURE <br />