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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 1/-;1//_/)(--- <br />DATE RECE lVED /IL -'t-:- ~ <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />/ OWNER'S NAME t}..!) \A..L. '- If:>.. r ~ <br /> <br />Q c:3 &-UC3- '::. <br /> <br />PHONE <br /> <br />//JOB ADDRESS <br /> <br />s- ~ \. cr_ - <br /> <br />l~~ Sr- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <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 />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <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 />.~. :;D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF W~~ C\:\--i\-WQ.S- <;~I\..~, ?A-w~ {LU~ I r.l'.._ <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 />o BUILDING <br />~~CTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br /> <br />PERMITS REQUESTED <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 AREAD YES 0 NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN ~~~ <br />SIGNATURE ~ <br /> <br />COMPANY 7--.-l-\lll ~ l~\_Ec(- . <br />STATE CERT OR REGIST# ~~t~~ <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 />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />