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<br />I'I!!
<br />CI~Y 0' ZEPHYRHILLS PERMIT APPLICATION
<br />BUI:LDING !DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542
<br />I 813-780-0020 FAX: 813-780-0021
<br />DATE RECE IVED
<br />I
<br />I
<br />i PHONE CONTACT FOR PERMITTING
<br />
<br />WORK PROPSED:
<br />
<br />
<br />PHONE
<br />
<br />OWNER'S NAME
<br />
<br />SUBDIVISION (! JI/(cr/le #"}I;21
<br />
<br />PARCEL ID f!:
<br />
<br />
<br />o ADDITION
<br />
<br />o ALTERATION
<br />
<br />o REPAIR
<br />
<br />f:h:NSTALL
<br />
<br />o SIGN
<br />PROPOSED USE: OSGL FAMILY
<br />
<br />o MOVE
<br />
<br />o DEMOLISH
<br />
<br />o COMMERCIAL
<br />
<br />OMULTI-FAMILY
<br />o INDUSTRIAL
<br />
<br />Of!: 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 />BUILDING SIZE
<br />
<br />SQUARE FOOTAGE
<br />
<br />HEIGHT
<br />
<br />RESIDENTIAL: ATTACH (2) PL ~ PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.
<br />COMMERCIAL: ATTACH (3) SE S OF BUILDING PLANS & (1) SET ENERGY FORMS.
<br />IF SIGN PERMIT ONLY (2) S ~S OF ENGINEERED PLANS REQUIRED.
<br />PROPERTY SURV ~ REQUIRED FOR ALL NEW CONSTRUCTION.
<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 SPECIA 1lY
<br />
<br />VALUATION OF MECHANCIAL INSTALLATION
<br />~HER
<br />
<br />$
<br />
<br />TYPE OF CONSTRUCTION: 0 BLO M
<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 />
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<br />iiFt:..\~~~J.;jL1!L':""~...~~"':~~:J,~...,.t_ ~..lW.._':"""____________ __~~__ _~~I ~~-,,--~D~ 1 ,I " ,_11.", .-/t l~ ~"
<br />
<br />BUILDER COMPANY
<br />
<br />SIGNATURE STATE CERT OR REGIST f!:
<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 f!:
<br />
<br />************** ~**************************************************
<br />
<br />MECHANICAL COMPANY
<br />
<br />SIGNATURE STATE CERT OR REGIST #
<br />
<br />SIGNATURE
<br />
<br />
<br />i
<br />*****,**********~*************************************************
<br />, COMPANY AilrJZJ{>oA -JZ/.
<br />
<br />OTHER
<br />
<br />STATE CERT OR REGIST #
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