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<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION <br />I <br />BUI:LDING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542 <br />I 813-780-0020 FAX: 813-780-0021 I <br />. 'BATE RECEIVED ~\-io--~ <br />i Du,'\.- /Z.tQ. C01'-U~h~- H?L.a_ <br />, PHONE CONTACT FOR PERMITTING ~l?) 78g~ C7> .3 <br /> <br />c~ ~ 6S <br />JOB ADDRESS 3l1L\ <1. C'J ~U( ~ 38QS-:, <br />LEGAL DESCRIPTION: LOT (S) \J'1t,. !o <t ~fr 7 BLOCK <br />PARCEL 10 #\~_- 2~- ~ \ -00\0 - ()d-":J()() -6dotJ <br /> <br />c kUG- <br />)~) <br /> <br />PHONE I) 1..1- ,9 d..'" IoD <br />2~~',lt~ (~33~2- <br />SUBDIVISION CI'+v (~VV':~ <br /> <br />OWNER'S NAME <br /> <br />:JI~ <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br /> <br />~ADDITION <br /> <br />(OBTAIN FROM PROPERTY.TAX NOTICE) <br />o ALTERATION 0 REPAIR ~INSTALL <br /> <br /> Os I GN o MOVE 0 DEMOLISH <br />PROPOSED USE: OSGL FAMILY DWELLING '~LTI-FAMILY ~# OF UNITS o MOBILE HOME <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK Q (')uS\ r-sO \tUc..vJCt y ") <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE ldl2~\ <br /> <br />HEIGHT <br /> <br />It) i <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 REQUIREP FOR ALL NEW CONSTRUCTION. <br /> <br />~UILDING <br /> <br />PERMITS REQUESTED <br />f / '767J dJ <br />$. _ f _ VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <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 AREAO YES 0 NO <br /> <br /> <br />SIGNATURE <br /> <br />'~c..~i ~ w' edit r,~ <br /> <br />~_. <br /> <br />.,. A . <br />COMPANyDUY\.-~:t4 G:,,"<LJ{. e..~ <br />STATE CERT OR REGIST # ac - 13 zl Z I L{ <br /> <br />BUILDER <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 />OTHER <br /> <br />COMPANY <br /> <br />- <br /> <br />SIGNA URE A;;J~\.;, I ~P'lIM'Il :,"'/." <br />;,~;:~r',; , !~. ~'''''J!' ,~:'l.f; ft,..:'V , ~'f('" >~~~., ..;~~~,\ <br />. , I :.~;:~ '~',"!l,: :~::.~::'''~:'"'~' vM \'1;~14:}) <br /> <br />~ <br /> <br />.. <br /> <br />ST~TJ!, c=.. ~n <br /> <br />.,w,~: Y'. ",1 ',:::,j~ ;:;;".\,':i;!'Y~;," <br /> <br />. lJ:!~ ' ., . ,'...t!f\"~h. '~I,I, r~'#l .1 : <br />~ +.1. i' "'f;""r~','. . .t,,:.~[::" <br /> <br />~"....-... .. <br /> <br />--- <br />