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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/. /'1- 05- <br />f' . <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME[rne.tatJ r6,Y)+ <br />JOB ADDRESS3qStIQ QLl.atfZ <br /> <br />PHONE <br /> <br />L-6+1I-Z <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 />v\lORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />ltYfNSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <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 />o RESTAURANT <br />DESCRIPTION OF WO.RK (tAl}. JY)odel <br />BUILDING SIZE /'1 x35 <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COJvlMERCIAL: 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 />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <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 AREAO YES 0 NO <br /> <br /> <br />BUILDER <br />SIGNATUREW-,/I- I~ ~ <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br /> <br />EJ;,ECTRICIAN <br /> <br />****************************************************************** <br /> <br /> <br />COMPANY (!"u. ride/I <br /> <br />SIGNATURE o/,.~ 1.3 ~.Jp--- <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br />SIGNATUREk...!_ _ /.3~~ <br />r <br /> <br />COMPANY. Bu-/TCf~eld <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br />SIGNATURE c..../-,~ /5 ~ <br /> <br />****************************************************************** <br /> <br />Ig{) hr S- <br />. <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />