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<br />.11 <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 />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br /> <br />OWNER'S NAME <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # .' 0'. <br />WORK PROPSED: ~EW CONSTRUCT ON <br /> <br />~..,,-;:)() 0:' <br /> <br />c/cj <br /> <br />o ADDITION <br /> <br />o ALTERAT ION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />OSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY <br />o COMMERCIAL <br /> <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 />CJ <br /> <br />HEALTH DEPARTMENT APPROVAL <br />..-1'-. <br />v/2 7/., <br /> <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <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 PLANS <br />OF BUILDING PLANS & (1) SET ENERGY <br />!OF ENGINEERED PLANS REQUIRED. <br />~EQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br />~LECTRICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />- --- <br /> <br />AMP SERVICE <br /> <br />[5 Progress Energy 0 <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 SPECIALT <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 />I S PROJECT IN FLOOD ZONE AREA 0 YES 0 NO <br /> <br /> <br />BUILDER COMPANY <br />SIGNATURE STATE CERT OR REGIST #~~ C j .J t::7r) ~: / '1? <br /> <br />**************** ************************************************* <br /> <br />ELECTRICIAN ~ <br />/......U"',,_..- <br />SIGNATUREC <br /> <br /> <br />/'1 <br /> <br />COMPANY ~L,,.j~i G /.> ,) C('>.<J./P4r.!7/i>.;- <br />STATE CERT OR REGIST # <br /> <br />************************************************* <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />******************:k*********************************************** <br /> <br />MECHANICAL COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />**************** **************************************k******** <br /> <br /> <br />OTHER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br />