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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUI;LDING DEPARTMENT 5335 arK St, Zephyrhills, FI. 33542 <br />I 813-780-0020 FAX: 813-780-0021 II - 1(, , oS' <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING g/3- ?a:'.;(-O?c>t~ <br /> <br />OWNER'S NAME ~.L'0""o,-A.~~ ~~ PHONE ((1-3 - 7f ..1-0c?4S <br />JOB ADDRESS~_ Lf>u /q .,2f~ ,~t:A :, ~_' <br />LEGAL DESCRIPTION: LOT(S) Q)Do<Vc 1- BLOCK D.3~00 SUBDIVISION or~ <br />PARCEL 10 # I t..f-d-..(o ~ .tOlill 'O.SS'c.O - ~o'C.) (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />, \ <br /> <br />WORK PROPSED: ~ CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />OSIGN <br />PROPOSED USE: ~L FAMILY DWELLING <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-FAMILY <br /> <br />0# OF UNI'fS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />o COMMERCIAL <br /> <br />o INDUSTRIAL <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WOR!( :.} ~ ie..,~. ~~ <br />BUILDING SIZE 3'7f.;tf /\/::;'D",[;>I( SQUARE FOOTAGE 957'7 (Cf.A-L EIGHT g <br /> <br />iJ'"BUILDING <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 />P/~s e---nfiJ-e.. -. .:r-~~ <br />PERMITS REQUESTED <br />, f:)6> <br />$ /30,00D <br />~DO <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D"ELECTRICAL <br />~UMBING <br /> <br />~ECHANICAL <br />o GAS ~FING <br /> <br />AMP SERVICE <br /> <br />~Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />'2 .c,C!:> <br />..:::/j ~ c.€.> <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ~OCK <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 43'4i1o <br /> <br /> <br />BUILDER <br /> <br />~ COMPANY <br />:h ' '. ~ '.c'V STATE CERT OR REGIS'- ~ ~IY-- 035'/3<1. <br />, 0 <br /> <br />**********~ ********;********************************************* <br /> <br />~~ () '"' ~~d~ <br />COMPANY c: ~~ ~~ <br />STATE CERT OR REGIST # Cr<.. f9t)rt.( 59/ <br /> <br />SIGNATURE <br /> <br />ELECTRICIAN ,~, ~~~ <br />SIGNATURE 'l)ol-lL-{" j' .6' <br />'- ( ( <br />\.. <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />t:. <br /> <br />COMPANY ~I ,1J.)~ <br />STATE CERT OR REGIST # c...~- /t..f;).5 &O~ <br /> <br />PLUMBER <br /> <br /> <br />MECHANICAL ./ <br />SIGNATURE niL~ <br />r <br /> <br /> <br />********************"1*******"'~'*~.****** l, ~. <br />/ COMPAN~~ ' .~ <br /> <br />r' -~;" I.-/r STATE CERT OR REGIST * ~ S>/~S7.~ <br /> <br />*********'~** <br />'" .- <br /> <br /> <br />OTHER ~o~ <br />SIGNATURE ,~', ,:. .' ~ <br /> <br />, <br />*******~****************************************** <br /> <br />COMPANy-Rq---m~~ <-\L.,~ <br />STATE CERT OR REGIST # C~ ),3.;!55 as <br />