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<br />I I <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8rK St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE: RECEIVED <br /> <br />/O-/D- f)~ <br /> <br />PHONE QONTACT FOR PERMITTING <br /> <br />I <br />OWNER'S NAME C rand 1-10 (12 () /) <br />JOB ADDRESS 77/ g Ld~eo.. <br />LEGAL DESCRIPTION: LOT(S) I <br />I <br /> <br />PHONE <br /> <br />L61 23i <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY.TAX NOTICE) <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY aWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />~OBILE HOME <br />o OTHER <br /> <br />_ 0 fESTAURANT <br /> <br />DESCRIPTION OF WO.RK ;Yloblle flory'/! <br />tl () i. .'/--1 <br />BUILDING SIZE 6 ~ / <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />5(1- Lip <br />, <br /> <br />SQl1-ARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLaT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SE~S OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) smTS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURV~Y REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />PERMITS REQUESTED <br /> <br />{j5DD2 <br /> <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 CI <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALlrY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOck <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 I <br /> <br />~ <br />SIGNATUREW~ ~ . -.. ..-e:>-- <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br /> <br />***************1************************************************** <br /> <br /> <br />E~ECTRICIAN I COMPANY /4 CP. /l;J'.i'41If C:;Dfee- <br />SIGNATUREi0-- ~?'dq ({,,-_, STATE CERT OR REGIST I <br />***************1************************************************** <br />COMPANyBIA-1fed^e1 d: <br /> <br />PLUMBER <br /> <br />SIGNATURE .(. <br /> <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE L-~ <br /> <br />\ <br />******************************************~*******t:~7********* <br />I ._ COMPANY - e ~ , ,f'pA)K_ :201-"12 <br /> <br />STATE CERT OR REGIST # <br /> <br />/7. <br /> <br />MECHANICAL <br /> <br />*************** ***************************************,********* <br /> <br />OTHER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br />