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<br />I I' <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 gTR St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:B13-7BO-0021 <br /> <br />DATE RECE lVED <br /> <br />9h~5 <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />O~NERIS,NAME~O~ S~SC/\^- <br />JOB ADDRESS 3901 S CQ>...d~ ~ <br />I <br />LEGAL DESCRIPTION: LO~(S)~ BLOCK <br />PARCEL ID # I '5 . ~l9' d , - 0 I ~D' 'DOO()() - 0/1r) <br />WORK PROPSED: DNEW CONSTRUCTioN D ADDITION <br /> <br />PHONE <br /> <br />7/5. <+'Rio 7 <br /> <br />SUBDIVISION <br /> <br />(ORTAIN FROM PROPERTY TAX NOTICEI <br /> <br />. DSIGN <br /> <br />, 0 MOVE <br /> <br />DALTERATION <br />o DEMOLISH <br /> <br />D REPAIR <br /> <br />D INSTALL <br /> <br />PROPOSED USE: [JSGL FAMILY DW1LLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />[J# OF UNITS <br />DSWIMMING POOL <br /> <br />[J MOBILE HOME <br />DOTHER <br /> <br />o REfTAURANT & HEAI:.TH DEPARTMENT APPROVAL <br />D'.CRIP~ION OF WORK ~ Iau..~ (i'DQlllo!.JkJJ",Lr---. Wi SuJ.D~ 9A<e.l="-V:. <br />BUILDING SIZE I SQUARE FOOTAGE In,.1 c.f 'HEIGHT g . <br /> <br />[J BUILDING <br /> <br />I <br />i <br />RESIDENTIAL: ATTACH (2) PLOT IpLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETSSOF BUILDING PLANS & (1) SET ENERGY FORM~~. . . 1_ .4-./, _ . . ... . <br />IF SIGN PERMIT ONLY (2) SET OF ENGINEERED PLANS REQUIRED. - 4J~ ~ <br />~ PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br /> <br />~\~ ~ERHITS REQUESTED (n~J-Oq20) <br />$ 33,9tO.fO <br />. I AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[J ELECTRICAL <br /> <br />o FLORIDA POWER <br /> <br />o ~:::: <br /> <br />( p~ <br /> <br />INS~AL~ION ~ <br /> <br /> <br />0, PLUMBING <br />} [J' MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL <br />o OTHER <br /> <br />[JGAS <br /> <br />. ,0 ROOFI~G ,': D SPECIALTY! <br /> <br />TYPE OF,CONSTRUCTION: 0 BLOCK! <br />FINISHED FLOOR ELEVATIONS <br /> <br />D FRAME <br /> <br />o STEEL <br /> <br />[J OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES 0 NO <br /> <br />CONTRACTOR:fiS~CT:tO~ <br />"~.,"-':.:~ ;.., I., ..L;t'......:.:.:-:\i~:".~~..,......;':;\..' ". ,.".,', ........ ".- ..1'.:.... ." <br /> <br /> <br />?p D." COOPANY~Z;'%~.~ <br />V u 9-/ <br />STATE CERT OR REGIST # c,PC ,;J:cr-h7/3 <br /> <br /> <br />SIGNATURE <br /> <br /> <br />*********:;.t************************************ <br /> <br /> <br />~-5' COMPAN~e-~ ~~~~J,.Ju..e . <br />STATE CERT OR REGIST # t-c, 1300 / ~63 <br /> <br />ELECTRICIAN <br /> <br /> <br />PLUMBER <br /> <br />MECHANICAL <br /> <br />**************J********************.**.***********.************ <br />, <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER <br /> <br /> <br />***************** <br /> <br />.....~..........:~::~~~..~~~ <br /> <br />STATE CERT OR REGIST # ctC....Osg/3 y. <br />