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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhil1s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />/f-/'1-0) <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />JOB ADDRESS <br /> <br />YR(J,J-fTf, (;- <br />(p q J I ,J DR -(/J L-ov/L L DIL <br /> <br />PHONE <br /> <br />OWNER'S NAME <br /> <br />1-6- f' '1 f.-H I J-L-s, <br /> <br />335+y <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />() 3- .,J.,/, - J- I - 0 I g 0 - 0 0 0 () 0 - 0 lJ go <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: D NEW CONSTRUCTION <br /> <br />DADDITION <br /> <br />DALTERATION <br /> <br />D REPAIR <br /> <br />D INSTALL <br /> <br />Do/GN <br />PROPOSED USE: ~GL FAMILY DWELLING <br />D COMMERCIAL <br /> <br />D MOVE <br /> <br />D 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 />BUILDING SIZE <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />~OO~ "/0 fWD ~fl.-Ac.-f f'\t+ll WI ~ Iill\e~~l-t..e 3-0 )l/,;J6-t.c <br />~5f)O <br /> <br />SQUARE FOOTAGE <br /> <br />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 />PERMITS REQUESTED <br /> <br />D BUILDING <br /> <br />$ <br /> <br />1t50.~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D Progress Energy D <br /> <br />W.R.E.C. <br /> <br />D PLUMBING <br />o MECHANIC~ <br />o GAS ~ROOFING <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />D FRAME <br /> <br />o STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D 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 />SIGNATURE <br /> <br />~orlAif <br />('1~.:L K~ <br /> <br />COMPANY <br /> <br />1/ /-\/ f}/lE '1.- <br /> <br />f.o 0 FII~ (j <br /> <br />OTHER <br /> <br />STATE CERT OR REGIST # <br /> <br />C-c c... () S ~ ~') , <br />