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<br />I 111 <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING bEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />PARCEL ID # <br /> <br />3<S-CfS-e <br /> <br />BLOCK toooo SUBDIVISION (jY~vleW ~ll S <br />I-O)c>O-"~ -(]6q <br /> <br /> <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />[J SIGN <br /> <br />[JADDITION <br /> <br />[JALTERATION <br /> <br />[J REPAIR <br /> <br />IM-"nJSTALL <br /> <br />[J MOVE <br /> <br />[J DEMOLISH <br /> <br />PROPOSED USE: [JSGL FAMILY <br />[J COMMERCIAL <br /> <br /> <br />[JMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J # OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOME <br />[J OTHER <br /> <br />& HEALTH DEPARTMENT APPROVAL <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 />~LANS & (2) SETS OF BUILDING PLANS <br />QF 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 />[J BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[J ELECTRICAL <br /> <br />'AMP SERVICE <br /> <br />[J Progress Energy [] <br /> <br />W.R.E.C. <br /> <br />[J PLUMBING <br />[J MECHANICAL <br /> <br />o GAS <br /> <br /> <br />o ROOFING <br /> <br />o SPECIALT <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />~HER <br /> <br />$ <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />o FRAME <br /> <br />[J STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES <br /> <br />[] NO <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />*********************************************** <br /> <br />ELECTRICIAN COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />***************** ************************************************ <br /> <br />PLUMBER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />***************** <br /> <br />************************************************ <br />i <br /> <br />COMPANY <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER <br /> <br />******************r********************************~************* <br /> <br /> <br />. " COMPANY -fJfiIf~/CJr?.LII --17tt- <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />