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<br />I r <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 />37S<;O <br /> <br /> <br />PHONE CONTACT FOR <br /> <br />/OJ~5 <br />D.MSO&PtiiJMIT SERVICF <br />1-866-824-7894 <br />PERMITTING Toll Fr-cc <br /> <br />OWNER'S NAME <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />{Jet( <br /> <br />Ave <br /> <br />PARCEL 10 # <br /> <br />l/3 <br />3lf oLJ - / 0/70 - O()o()U -d- t/J(J <br /> <br />BLOCK <br /> <br />SUBDIVISION t:r((j'~Jj I!dl/21Yu P3 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />WORK PROPSED: ~EW CONSTRUCT ON <br />OSIGN <br /> <br />o ADDITION <br /> <br />o ALTERAT ION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: []SGL FAMILY OW 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 /> <br />DEPARTMENT APPROVAL <br /> <br />SQUARE FOOTAGE <br /> <br />(S'~/l <br />/JYO f <br /> <br />I?XJ /?f... <br /> <br />JLO 4'lctifJ <br />(./ <br /> <br />/(J(JfrJ <br /> <br />BUILDING SIZE <br /> <br />IS f 1\ I &- f <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 /> PERMITS REQUESTED <br /> 7 iSO. 0 <br />P BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br />9i ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br />o PLUMBING <br />o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION <br />o GAS o ROOFING o SPECIALT 0 OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />[] 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 />COMPANY <br /> <br />SIGNATURE <br /> <br />~Uk <br /> <br />STATE CERT OR REGIST # <br /> <br />************************************************* <br /> <br />SIGNATURE <br /> <br />wi~ <br /> <br />~r; ,~~) <br /> <br />COMPANY ~/A61 Clads <br /> <br />{'tee/rIA! <br /> <br />ELECTRICIAN <br /> <br />STATE CERT OR REGIST # <br /> <br />PLUMBER <br /> <br />****************l************************************************* <br /> <br /> <br />. COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />**************** ~*********************************************** <br /> <br />OTHER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br />