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<br />CITY J' ZEPHYRHILLS PERMIT APPLICATION <br />BUr'LDING i DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />/0- 1~-6J~ <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br /> <br />\o/V <br /> <br />/--~ <br />PHONE(~ '2'13 - ~ 0'1.- l:7 (0 I~ <br />30<(:-"37(00 <br /> <br />. Lt.~ <br /> <br />JOB ADDRESS '3 <\ 0 C3 ~ <br /> <br />litJc:. 2_ <br /> <br /> <br />LEGAL DESCRIPTION: LOT{S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />o SIGN <br />PROPOSED USE:~SGL FAMILY <br />o COMMERCIAL <br /> <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />WORK PROPSED: <br /> <br />o MOVE <br /> <br />o DEMOLISH <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 />. 'vi) <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PL <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 & (l) SET ENERGY <br />S OF ENGINEERED PLANS REQUIRED. <br />REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (l) SET ENERGY FORMS. <br />FORMS. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />';;l ~t)O.(.? 6 <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 />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIAL Y <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: r)i 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 AREAo YES 0 NO <br /> <br /> <br />BUILDER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />*************** ***************************************'k********** <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 />MECHANICAL COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />*************** ************************************************* <br /> <br />OTHER <br /> <br />, <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />