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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/ O~ <br />DATE RECE IVED / /- / (; . <br /> <br />PHONE CONTACT FOR PERMITTING g'/3-!i-S1-77?-O <br /> <br />OWNER'S NAME <br /> <br />I5f?/rY <br />'17;) ea <br /> <br />1-+ ,th~ f'1(t (,) U 0 <br />/9 1--4 . Sf-. <br /> <br />PHONE g 13- 7tff - 'l<ftJ :2 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br /> <br />[JADDITION <br /> <br />[JALTERATION <br /> <br />[J REPAIR <br /> <br />[J INSTALL <br /> <br />PROPOSED <br /> <br />o SIGN <br />USE:)(SGL FAMILY <br />[J COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DWELLING <br /> <br />[JMULTI - FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />~A:-lz.. OFF 5t+;,..j~LE""S ll\.)S/A-LL ,..U;/,t) '$-TA~ ~H;^j(7Lt[S <br />ON riD/....€: oJl.).y <br />SQUARE FOOTAGE HEIGHT <br /> <br />DESCRIPTION OF WORK <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />/S-g~1 1~ <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[J Progress Energy [J <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br /> <br /> <br />[J MECHANICAL $ <br /> <br /> <br />o GAS ~ROOFING 0 SPECIALTY <br /> <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <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 />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 />OTHER Ro~ <br /> <br />SIGNATURE V - - - - ~ ~g <br /> <br />COMPANY T? p/-(. (7....-0L.J.'\. /?ocsf: J Iv <:.. <br />STATE CERT OR REGIST # C((OY7'370 <br />