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<br />I II <br /> <br />CIty OF ZEPHYRHILLS PERMIT APPLICATION ~ <br />BUIIj.DING DEPARTMENT 5335 9"" St, Zephyrhilb, n. 33542 0 '2 ~ <br />913-790-0020 FAX: 913-790-0021 / ~ l'~ <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />WORK PROPSED: <br /> <br /> <br />o SIGN <br /> <br /> o ADDITION o ALTERATION o REPAIR o INSTALL <br /> o MOVE 0 DEMOLISH <br />DWELLING OMULTI-FAMILY O. OF UNITS o MOBILE HOME <br /> o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />Cd L.t:?~/ , <br />C(J'VP~ <br /> <br />OWNER'S NAME <br /> <br />~eL <br />7" <br />BLOCK __ SUBDIVISION ~~Y~/U-.f' <br />t:::1c:?/ tt:I ~~ t1t:J c;1;;;aAr.,RTAIN FROM PRO:F::~ TAX NOTTCE) <br /> <br />PHONE <br /> <br />t:f> /.3 <br /> <br />7Po? ~rb.p <br /> <br />JOB ADDRESS <br /> <br />PROPOSED <br /> <br />DESCRIPTION OF WORK <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />C/4/tP- 6X7FJe./(//f ~ClW <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) <br />COMMERCIAL: ATTACH (3) <br />IF SIGN PERMIT ONLY (2 <br />PROPERTY S <br /> <br />P~OT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS, <br />SpTS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />SETS OF ENGINEERED PLANS REQUIRED. <br />RVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />o BUILDING <br /> <br />$ <br /> <br /> <br />PERMITS REQUESTED <br />,(1) VALUATION OF TOTAL CONSTRUCTION <br /> <br />o EU~CTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />--if <br />,)0:1- ( <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 SPEC ALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BOCK <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 />BUILDER <br /> <br /> <br />I <br />NC <br /> <br />STATE CERT OR REGIST. 06- C ();;J.;;lfd / 1/ <br /> <br />* .***.. * * * ** ** **... ****.. *** **. ** * .,**** * * ** * ********** ********* *** 5z I )"'.:::::. <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST . <br /> <br />************* *********************-******************************* <br /> <br />PLUMBER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST . <br /> <br />MECHANICAL COMPANY <br /> <br />************* **************************************************** <br /> <br />, <br />.. ...... '*.. .. '* '* . *.. * * 4- *.......... * .... * * * .. * * *.... *.... *.. * . * ........ *.. .... ... *..... *... * * ... * * *......... <br /> <br /> <br />SIGNATURE STATE CERT OR REGIST ~ <br /> <br />SIGNATURE STATE CERT OR REGIST . <br />