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<br />111 <br /> <br />CITY 0 :ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING ~PARTMENT 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 />Os I GN <br /> <br /> <br />PHONE <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />PARCEL 10 # <br /> <br /> <br />SUBDIVISION <br /> <br />- }3S~ <br /> <br />(?Ve~tVlr-w 140 <br /> <br />LEGAL DESCRIPTION: LOT{S) <br /> <br /> <br />WORK PROPSED: oNEW CONSTRUCT <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />~STALL <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 />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 />FLANS & (2) SETS OF BUILDING PLANS <br />~F BUILDING PLANS & (I) SET ENERGY <br />I <br />iOF ENGINEERED PLANS REQUIRED. <br />~EQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (l) SET ENERGY FORMS. <br />FORMS. <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALT <br /> <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />o ELECTRICAL <br /> <br />SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />~THER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <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 /> <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 />***************** ************************************************ <br /> <br />PLUMBER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />***************** <br /> <br />1*********************************************** <br />COMPANY <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************** <br /> <br />************************~~************ <br /> <br /> <br />COMPANY I ( f) n +rLf) <br />.. . <br /> <br />SIGNATURE <br /> <br /> <br />STATE CERT OR REGIST # <br /> <br />OTHER <br />