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<br />I I <br /> <br />CITY OF ZEPBYRBILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8~ St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />jtJ-/3--os- <br />, <br /> <br />PARCEL 10 # <br /> <br /> <br />fJ PHONE CONTACT FOR PERMITTING 7;).. 7 -14lo- 7/0 0 <br />tJ/Jv /?/lEOIAWPLr <br /> <br />OWNER'S NAME <br /> <br />PHONE/J..1-'Z A,lo -/100 <br /> <br />JOB ADDRESS <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br /> <br />PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: 0 NEW <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br />PROPOSED USE: ~GL FAMILY <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 />DESCRIPTION OF WORK <br /> <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o <br /> <br /> <br />o OTHER <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 PLAN <br />OF BUILDING PLANS & (1) SET ENERG <br />OF ENGINEERED PLANS REQUIRED. <br />REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br /> <br />VALUATION OF <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF <br /> <br />o GAS ~OOFING <br /> <br />o SPECIALT <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION:~ BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br /> <br />BUILDER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />**************** ************************************************* <br /> <br />ELECTRICIAN COMPANY <br /> <br />SIGNATURE <br /> <br />I ! STATE CERT OR REGIST # <br />I <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br /> <br />STATE CERT OR REGIST # <br /> <br />**************** <br /> <br />~*********************************************** <br /> <br />SIGNATURE <br /> <br />COMPANY 1.-;;) CholCQ.. AoorlNb /N~ <br />STATE CERT OR REGIST # !<C-OS-t3b-1 <br /> <br />OTHER <br />