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<br />r:< ,tiS. <br />. \\Y <br /> <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 />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMH'TING <br /> <br />5dl-Lfq 77 <br /> <br />OWNER'S NAME <br /> <br />f3&+~ t.i <br />f.t;~i.J . ,/ pU Cf <br />I <br />r; I -00000 _ r <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION _.Dri'+twot.YJL UrY\do 5 <br /> <br />PARCEL 10 # <br /> <br /> <br />o <br /> <br />WORK PROPSED: 0 NEW <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />W'REPAIR <br /> <br />o INSTALL <br /> <br />OSIGN <br />PROPOSED USE: []SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />D <br /> <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />/tIc 5 s-tern <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />, <br />RESIDENTIAL: ATTACH (2) PLO~ PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SET~ OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SE~S OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEk REQUIRED FOR ALL NEW CONSTRUCTION. <br />I <br />i <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 [J <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />P(MECHANICAL <br /> <br />$ <br /> <br />Lf-4ooj. 00 <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOC~ <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE: AREAO YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />i <br />j STATE CERT OR REGIST # <br />*************** ***************************************~,********** <br />I <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************J**************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />* * *.* *t * */!'J* * ** <br /> <br />lk is /'t/(' <br /> <br /> <br />SIGNATURE <br /> <br />~J/Y11A.- <br /> <br /> <br />STATE CERT OR REGIST # <br /> <br />*************** ************************************************ <br /> <br />OTHER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br />