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<br />r <br /> <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 />PHONE CONTACT FOR PERMITTING <br /> <br />, <br />o.WNER'S NAME <br /> <br />PHo.NE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTIo.N: Lo.T(S) <br /> <br />BLo.CK <br /> <br />SUBDIVISIo.N <br /> <br />PARCEL 10 # <br /> <br />(OBTAIN FRo.M PRo.PERTY TAX No.TICEl <br /> <br />Wo.RK PRo.PSED: DNEW CONSTRUCTIo.N <br /> <br />DADDITIo.N <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o Mo.VE <br /> <br />o DEMo.LISH <br /> <br />PRo.Po.SED USE: DSGL FAMILY DWELLING <br />o Co.MMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# o.F UNITS <br />o SWIMMING POo.L <br /> <br />o Mo.BILE HOME <br />o o.THER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPRo.VAL <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />SQUARE Fo.o.TAGE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLo.T PLANS & (2) SETS o.F BUILDING PLANS & (1) SET ENERGY Fo.RMS. <br />COMMERCIAL: ATTACH (3) SETS o.F BUILDING PLANS & (1) SET ENERGY Fo.RMS. <br />IF SIGN PERMIT o.NLY (2) SETS o.F ENGINEERED PLANS REQUIRED. <br />PRo.PERTY SURVEY REQUIRED Fo.R ALL NEW Co.NSTRUCTIo.N. <br /> <br />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />VALUATIo.N o.F To.TAL Co.NSTRUCTIo.N <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 /> <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATIo.N o.F MECHANCIAL INSTALLATIo.N <br /> <br />o GAS <br /> <br />o Ro.o.FING <br /> <br />o SPECIALTY <br /> <br />o o.THER <br /> <br />TYPE o.F Co.NSTRUCTIo.N: 0 BLo.CK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o o.THER <br /> <br />FINISHED FLo.o.R ELEVATIo.NS <br /> <br />IS PRo.JECT IN FLo.OD Zo.NE AREAD YES 0 NO. <br /> <br /> <br />SIGNATURE <br /> <br />~W1/ <br /> <br />Co.MPANY f\.JAJko€.lL 1J1,1-/~"-I"'LS(/r rL lAIC <br />STATE CERT OR REGIST # C-'&:L (!!J 1 76' 'I Z- <br /> <br />BUILDER <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />Co.MPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT o.R REGIST # <br /> <br />****************************************************************** <br /> <br /> <br /> <br />:::::RE ~ "."" iL G40M.J :::::N:ERT OR REGIST <br /> <br />~tH'HHHHHHHHH'H'HHHH'HHHHHHHH'HHHHHH \. ';1 <br />MECHANICAL Co.MPANY G ~ G. ; 1116. :!i.e.. 1)8/1 64iJ.- <br />~/G. <br /> <br />STATE CERT OR REGIST # <br /> <br /> <br />YIGNATUR0 <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />" <br />