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<br />1'1' <br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION <br />BUIr:LDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br />, " DATE RECE IVED <br />I <br /> <br />OWNER'S NAME <br /> <br />I <br />I <br />S c:: .4 MCfZ- <br /> <br />~ 3 3VD /.L1 <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />JOB ADDRESS' '3 <br /> <br />Co/LjJ <br />j <br /> <br />4- i/({; <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br /> <br /> <br />WORK PROPSED: 0 NEW CONSTR CTION <br />o SIGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />M'T ERAT I ON <br /> <br />r:Hli:PAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-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 />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />c <br />-reOO.;:::'/~?> J~ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) P OT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) S TS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURV Y REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />o BUILDING <br /> <br />jj <br />l~tJO <br /> <br />o'? <br /> <br />PERMITS REQUESTED <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL $ <br />o GAS ~FING <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o SPECIA TY <br /> <br />o OTHER <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 />11~~~~ffil~~t;;r~:~zr/~~:-"~~"'~~A""~c~';:rr;r"7~~-:- P~~~" ~ :~1-~-~'~i ~~ ~~_~_r-----~__ -~ - ~ ',"-'" ;1 ~~;;~i_H;, '7:~''''~F-~~:('~1~0~~:11~J!E~i~4;~t <br />(. llf~'" I' r~~l)t;fllr WI 'I P ," & l ' Il~I"' .,1 I " I t 1 1 ' j , h I U;I" I 1...1 , . 0- ~l" 1 )",,~!tfjii !~;W;<En').r <br />_~~_liJ.;~.LmL~~~~~~.:j:.~~,l~,-~ _~I~~______________________~__ __'~~.~~~'~ " ',0 'II I , ,_ _~.?tt' ~:;, ) ' <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />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 />**************************************************************t** <br /> <br />OTHER <br /> <br /> <br />, ( <br />?-At//rJ <br />~ <br /> <br />/'1A / . J /J O,r'\ -/) . /,~ <br />COMPANY (r, t/ / ;.., .It..- v -- )/V, <br />STATE CERT OR REGIST # I- c. 0 0 'I ~ Z '-/ I <br /> <br />SIGNATURE <br />