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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 //- //- D~--- <br />DATE RECE IVED L!- L~ <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />/""'OWNER' S NAM~M\.aV\ 4- ~10( mc~ I l-\e inn f\ d-ez PHONE (&-~) 779 - 9R00 <br />/JOB ADDRESS 3~/t.f.;) qfh AV~ 'Zef hy ( Vl: \ l ~ F( ~~s-ifd <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />"'---- .---;:~.~:'~."';:':':': ~_:~~.;= .---"; <br />- <br /> <br />PARCEL 10 # <br /> <br />/1- ~iP --,;z./-OO/ {) -I) 9; tJo ~ D ::J / u <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <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 />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORKLte.Q( dvL0n .-kCHY,€ +VOn+ PtJfcJ) <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />.----. <br /> <br />/1:3~ <br />PERMITS REQUESTED I J\. ? <br /> <br />VALUATION OF TOTAL CONST~:~ON~' <br /> <br />./ <br /> <br />\ <br />) <br /> <br />~'BUILDING <br />o ELECTRICAL <br /> <br />$ <br /> <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <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 />SIGNATURE')('-r\ 0 ~ rn:\. "J . jJ.01 rvJnn1air- <br /> <br />COMPANyfl hOfh-t' tiJ )r'l~ r <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 />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />