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<br />II' <br /> <br />JOB ADDRESS <br /> <br />/t7IP~~- <br />DATE RECE IVED '/ I <br />PHONE CONTACT FOR PERMITTING '3 S 4> )'rfp!J y.. <br /> <br />\'~ ~ V~ m~ {( ~~E <br />3t.fJS r,,\.~_~ 2- ~ U(& . _ <br /> <br />LEGAL DESCRIPTION: LOT(S): BLOCK SUBDIVISION ~ ~~ <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 />OWNER'S NAME <br /> <br />PARCEL 10 # <br />WORK PROPSED: ~EW CONSTRUCTIbN <br />o SIGN <br />PROPOSED USE: DSGL FAMILY DWE~LING <br />o COMMERCIAL <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <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 />c=J RE$TAURANT & HEALTH DEPARTMENT APPROVAL <br />~(b~ lv\ SWQ <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />DESCRIPTION OF WORK <br /> <br />i <br />RESIDENTIAL: ATTACH (2) PLOT IPLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS~OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SET OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY ,REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />t> PLUMBING <br />o MECHANICAL $ <br />o GAS 0 ROOFING 0 SPECIALT1 <br />TYPE OF CONSTRUCTION: 0 BLOCK! <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />#1 f'1 & <br /> <br />o OTHER <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 />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />******************************************~.************.~********* <br />f'L~~~ <br />~ COMPANY~ . <br /> <br />':1rl ,.. STATE CERT OR REGIST # ()c:) ~ 'I 8<0 \ <br /> <br />****************************************************************** <br /> <br /> <br />PLUMBER <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />*************** *~*********************************************** <br /> <br />OTHER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br />