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<br />CITY <br /> <br />I I <br />OF ZEPHYRHILLS PERMIT APPLICATION <br />DEPARTMENT 5335 8TH St, Zephyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />I <br />BUiLDING <br /> <br />! <br />i <br />I <br />I <br /> <br />DATE RECE IVED <br /> <br />/ Vn/ /0 S- <br /> <br />. <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />'1k,., <br /> <br />PHONE ~3-~79~ <br /> <br />JOB ADDRESS <br /> <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL ID "" <br /> <br />/'-076 -<:t:) V&'- <br />o NEW CONSTRJCTION <br />! <br />I <br /> <br /> <br />WORK PROPSED: <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />;8(: NSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING ~ULTI-FAMILY <br />o COMMERCIAL 0 INDUSTRIAL <br /> <br />~ OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />BUILDING SIZE <br /> <br /> <br />DESCRIPTION OF WORK <br /> <br />RESIDENTIAL: ATTACH (2) P <br />COMMERCIAL: ATTACH (3) SE <br />IF SIGN PERMIT ONLY (2) S <br />PROPERTY SURV <br /> <br />T PLANS & (2) SETS OF BUILDING PLANS <br />S OF BUILDING PLANS & (1) SET ENERGY <br />TS OF ENGINEERED PLANS REQUIRED. <br />Y REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />o PLUMBING <br />~MECHANICAL $ ~~ VALUATION OF MECHANCIAL INSTALLATION <br />o GAS 0 ROOFING 0 SPECIA TY 0 OTHER <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />TYPE OF CONSTRUCTION: 0 BLO K <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 />_~~t=~}~=-;',~lli~~~:~~~'~_~~'.~~~.~l u ---~- - ,-- - _.~_ ~~~ :;,~::~~:~~~',~~"-~R~':'::r~';~:; 1;:~i~~~~~~~r; <br /> <br />BUILDER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST "" <br /> <br />************** *************************************************** <br /> <br />ELECTRICIAN COMPANY <br /> <br />SIGNATURE <br /> <br />I STATE CERT OR REGIST "" <br />I <br />**************~*************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST "" <br /> <br />SIGNATURE <br /> <br /> <br />***************************************************************::.~* ~~ <br /> <br />COMPANY .... ?~/f'v~ /4/1 <br />STATE CERT OR REGIST # c:. A-co51J'Y7&?Z <br /> <br />MECHANICAL <br /> <br />************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />