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<br />I Ii <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />PHONE CONTACT FOR <br /> <br />DATE RECEIVED /O-9~ <br /> <br />PERMITTING (/(3 - 711(- 9'1f/f <br />~'<- <br />_.5/3 - 5Y3 -~'/2-iJ <br />PHONE _>>3- 7$- 7.;L'g7L <br /> <br />OWNER'S NAME <br /> <br /> <br />SUBDIVISION k.f1eY"ald <br /> <br />AJ~f ~.; <br />~esorf <br /> <br />JOB ADDRESS <br /> <br />PARCEL ID # <br /> <br />. t:K)()OO _ 0 <br /> <br /> <br />I <br />WORK PROPSED: DNEW CONSTRUCT dm <br />I <br />DSIGN i <br /> <br />PROPOSED USE: [JSGL FAMILY DW~DLING <br />[J COMMERCIAL I <br /> <br />[JADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />13.. INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />[J# OF UNITS <br />o SWIMMING POOL <br /> <br />l&MOBILE HOME <br />o P~J'\L~ <br />OTHER <br /> <br />DESCRIPTION OF WORK -.S <br /> <br /> <br />PROVAL <br /> <br />5YBUILDING <br />~LECTRICAL <br />d'PLUMBING <br />~ECHANICAL <br /> <br />BUILDING SIZE / ), X </D I SQUARE FOOTAGE <br /> <br />RESIDENTIAL: ATTACH (2) PLOTj.~..LANS & (2) SETS OF BUILDING PLANS & (I)> SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS qF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SET IOF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />i <br /> <br />I <br /> <br />I <br /> <br />I VALUATION OF TOTAL CONSTRUCTION <br />: AMP SERVICE 0 Progress Energy ilJ <br /> <br />. " ) <br /> <br />HEIGHT <br /> <br />/81\\ <br /> <br />PERMITS REQUESTED <br /> <br />-it- 50 {o <br /> <br />$ Lit, 000 <br />\50 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br /><t~()" <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />[] GAS <br /> <br /> <br />[] ROOFING <br /> <br />[] SPECIALT <br /> <br />[] OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />LJ FRAME <br /> <br />[] STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 18' NO <br /> <br />STATE CERT OR <br /> <br />~.~ <br />REGIST # '-=s=.\\ ~ \:) \:)~L.\ ~ I <br /> <br />COMPANY <br /> <br />*****************~************************************************ <br /> <br />COMPANY <br /> <br />a L... 'j .,," C?- ("" <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANI <br /> <br /> <br />***t1************~~.*********************************************** <br />/j <br />Ii <br />.j <br />/ <br />I <br />,,/// <br /> <br />COMPANY G- ~ '.:) r\ <'G'>.^<"~.C('"\ 0-.." ~ ~-'--\ <br />STATE CERT OR REGIST # . ~~ c::. () cL.\ ~ I <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />~*********************************************** <br />// COMPANY a \.,...j()~~::- <br /> <br />STATE CERT OR REGIST # . <br /> <br />****************** ********************************************** <br />i <br />i <br /> <br />OTHER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br />