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<br />I I <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 />PARCEL 10 # <br /> <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />Cl)e C I <br /> <br />BLOCK OClXJQ <br /> <br />0- <br /> <br /> <br />SUBDIVISION C y~+ ({ c W \i11/..s <br /> <br />PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: 0 NEW <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />~STALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY <br />o COMMERCIAL <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 />& HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />\-cfc:-s <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 />WLANS & (2) SETS OF BUILDING PLANS <br />$F BUILDING PLANS & (1) SET ENERGY <br />'OF ENGINEERED PLANS REQUIRED. <br />REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL $ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALT <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />~HER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />~u(:e- <br />(pOTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />******************~*********************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />******************t*********************************************** <br /> <br />PLUMBER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br /> <br />***************** t*********************************************** <br /> <br />MECHANICAL COMPANY <br /> <br />OTHER <br /> <br />i <br />**************** *1*********************************************** <br /> <br />: COMPANLll1kJi(PnJl ~~i( ~C1~(~f) <br /> <br />~ STATE CERT OR REGIST # <br />