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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 STH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:S13-780-0021 <br /> <br />DATE RECEIVED <br /> <br />/()/3//{lS <br /> <br />f I <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME CfaIJJ Ho() 'lOt/) <br />JOB ADDRESS JJ52S ~J):J /Je {^- ~1 ~(lq <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br /> <br />PHONE <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FROM PROPERTY.TAX NOTICE) <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />cvINSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />0"'MOBILE HOME <br />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL <br /> <br />DESCRIPTION OF WQRK Jv1obJ.t. lk,YJ ( 5e! r 4.p <br />~/ yC;) <br /> <br />BUILDING SIZE <br /> <br />SQGARE FOOTAGE 5r.( I <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT 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) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL .NEW CONSTRUCTION. <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 />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <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 AREAD YES 0 NO <br /> <br /> <br />BUILDER <br />SIGNATURE~' <br /> <br />STATE CERT OR REGIST # <br /> <br />************* <br /> <br />**************************************************** <br /> <br />E~ECTRICIAN <br />SIGNATURE Ur ~.e_l!:> <br /> <br />COMPANY A( ( <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANy/:30tTn" -;;~A{j <br /> <br />SIGNATURE .t?-/~.....- D J~ ~. STATE CERT OR REGIST # <br /> <br />* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * t/* * * * * * * * * * * * * * * * * * * * *.* <br />MECHANICAL COMPANY Lf C L <br /> <br />SIGNATURE ~~ )3-<-,~~ S _~ STATE CERT OR REGIST ff <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />