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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />/1-/- rO~ <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 10 # ;) ,( - ) ~- <br /> <br />rb /,', ? "/ CA r (f , (A j i Ii l '^ ~ <br />1 <br /> <br />JOB ADDRESS ~$Ol t41c-. loc--y+-;{./ Dr. <br />0/(/ <br />:;J I - (}O Yu -{){}QUQ -1190 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />L-j/o ~ ~s /- 9.for- <br /> <br />OWNER'S NAME <br /> <br />PHONE <br /> <br />L+/\t?J <br />JG <br /> <br />cJ/ <br /> <br />SUBDIVISION <br /> <br />BLOCK <br /> <br />WORK PROPSED: ~EW CONSTRUCTION <br />OSIGN <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />.P(INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />%' MOBILE HOME <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br />c=J RESTAURANT & <br /> <br />K( I 4,/( <br /> <br />1 <br /> <br />!J )('-/11 <br />, . <br /> <br />HEALTH DEPARTMENT APPROVAL <br /> <br />f)1t)ctl ~f~u <br />:)00 -; <br /> <br />HEIGHT / .5 ' <br />, <br /> <br />DESCRIPTION OF WORK <br /> <br />SQUARE FOOTAGE <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PL~NS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~ BUILDING <br /> <br />$ <br /> <br />~J S () Q <br />jD !J <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />{Z) ELECTRICAL <br />rn PLUMBING <br />g:j MECHANICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />~SO 0 <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 ~FRAME <br />J t'~ 5;>" <br />FINISHED FLOOR ELEVATIONS <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br /> <br />SIGNATURE <br /> <br />S Aul1V1cj~ <br /> <br />/1- <br /> <br />-' <br /> <br />COMPANY tI..JA ~ (/ <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # .:zI!{),J;) (1 60Y <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />l) COMPANY <br /> <br />-11~/ ~-- <br /> <br /> <br />****************************************************************** <br /> <br />~~CtY1Y1~" IJ ~ <br />~ U4.~ <br /> <br />(! tJ-~ 6/ecJr ;C-/ <br />r <br />STATE CERT OR REGIST # .E:~ L~QQ. j'fltp3 <br /> <br />ELECTRICIAN <br /> <br />PLUMBER <br /> <br />COMPANY tJ!l!jh' L <br />STATE CERT OR REGIST # <br /> <br />%-tlSJI) rJ <br /> <br />SIGNATURE <br /> <br />J rlcJ,).:>c) 60 Y <br /> <br />MECHANICAL <br /> <br /> <br />SIGNATURE <br /> <br />************************************* ~ <br /> <br />COMPANY j))1; 1. 1 t--\. p!.JI'/ <br />STATE CERT OR REGIST # (l}cOS-) /1 f <br /> <br />~\ <br />" <br /> <br />? <br />~,/" <br /> <br />* * * * * * * * ** * * * * * * * * * * * ~*.*..* * *l(< * * * -<** * * *,*'* ** * *7. . ~ <br /> <br />.,}".J...t.-~ \ \', '" 1 I.,)~ <br />. \ ~.., i 1 <br /> <br />COMPANY' I . <br /> <br /> <br /> <br />STATE cW~~~ .$'~~'ST 4 ~~4"l <br />