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<br />I III <br /> <br />I <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDINGjDEPARTMENT 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 />, is -uS <br /> <br /> <br />PHONE <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />PARCEL ID # <br /> <br />~--, BLOCK <br />1\ 0 \ ZD <br /> <br /> <br />SUBDIVISION <br /> <br /> <br />l~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />WORK PROPSED: <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />EJ-'I"NSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: 0 SGL 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 />DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLO <br />COMMERCIAL: ATTACH (3) SET <br />IF SIGN PERMIT ONLY (2) SE <br />PROPERTY SURVE <br /> <br />PLANS & (2) SETS OF BUILDING PLANS <br />OF 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 />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIAL '[ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />~ER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOC <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br /> <br />BUILDER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />*************** ************************************************** <br /> <br />ELECTRICIAN COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />*************** *ik************************************************ <br /> <br />PLUMBER COMPANY <br /> <br /> <br />****************************************************************** <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER <br /> <br />~************************************************ <br /> <br /> <br />. COMPAN::AJJe.1\Cc~n VJ? <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />