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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-7BO-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME ,.G OL V' J <br />JOB ADDRESS ~ 7 \....[ 0 <br /> <br />MCA th ("q <br />. / <br />S I I v. e II 0 ~ ft s Ut <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 10 # Os 7 \::> L\ <br /> <br />BLOCK SUBDIVISION <br />o \ '- A.. oc::.oc::,u ot<t ~BTAIN FROM PROPERTY TAX NOTICE\ <br /> <br />WORK PROPSED: D NEW CONSTRUCTION <br /> <br />DADDITION <br /> <br />DALTERATION <br /> <br />D REPAIR <br /> <br />D INSTALL <br /> <br />D SIGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br />D COMMERCIAL <br /> <br />D MOVE <br /> <br />D DEMOLISH <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />D# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <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 />D BUILDING $ S; fVO VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL AMP SERVICE D Progress Energy D W.R.E.C. <br />D PLUMBING <br />o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION <br />o GAS o ROOFING o SPECIALTY 0 OTHER <br /> <br />TYPE OF CONSTRUCTION: D BLOCK <br /> <br />D FRAME <br /> <br />D STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <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 <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br /> <br />OTHER A 00 (7 0 7 <br />. / <br />SIGNATURE ~ <br /> <br />-- <br /> <br />COMPANY 5'1'6/7.64 c.{"'" ~ po ~r.,r;;; 3 <br />STATE CERT OR REGIST # (CC' oJ- 7 ,f'.{'-7 <br />