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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION 5\9~ <br />BUI:LDING DEPARTMENT 5335 aTH St, Zephyrhills, FL 33542 <br />I 813-780-0020 FAX: 813-780-0021 II t--z z..lo< <br />',: DA'rE RECE lVED _ __ _ <br /> <br />PHONE CONTACT FOR PERMITTING gI3-7a:'~-O~ct~ <br /> <br />OWNER'S NAME~ ~~~, PHON~ 1?!2,-'7a'.:1.-0d"-'4S <br /> <br />JOB ADDRESS _ _ -'::~1 -:::1-=--I--I\er-t n~ <br /> <br />LEGAL DESCRI PTION , LOT (S) t3D<{( ~:::L ') SLOCK ~3<foO SDSDIVI SION - - : _ a..... ~ <br /> <br />PARCEL 10 # 1'-/-;...)[,--21- DI<D -&/&;- DD..t, (OBTAIN FROM PROPERTY TAX NOTICE\ <br />, 01'10 .- C:>OOOO - Olao <br />WORK PROPSED: ~ CONSTRUCTION 0 ADDITION OALTERATION [J REPAIR 0 INSTALL <br /> <br />OSIGN <br />PROPOSED USE: ~L FAMILY DWELLING <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-FAMILY <br /> <br />D# OF UNI'I'S <br />o SWIMMING POOL <br /> <br />D MOBILE HOME <br />o OTHER <br /> <br />o COMMERCIAL <br /> <br />o INDUSTRIAL <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK Il~,..:> ~ I-e... ~~'~ ~~ <br />BUILDING SIZE t-jo' X 4/~ rf-f SQUARE FOOTAGE YY/~ r~ EIGHT C:?' <br />. , <br /> <br />ltr13UILDING <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 />P/~5 ~fiJ-e.. - /4[.5 "('(Vod~ <br /> <br />PERMITS REQUESTED <br /> <br />$ /3 q DOn- cD VALUATION OF TOTAL CONSTRUCTION <br />~()O <br /> <br />AMP SERVICE <br /> <br />~Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />~LECTRICAL <br />~UMBING <br />~ECHANICAL <br />D GAS ~FING <br /> <br />$ 3bt."YD, cO <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />D SPECIALTY <br /> <br />D OTHER <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 43-1i1o <br /> <br /> <br />BUILDER <br /> <br /> <br />COMPANY <br />STATE CERT OR REGIS'l' # ~~ D3's" /3cf <br /> <br />SIGNATURE( <br /> <br />****************************************************** <br /> <br />~ C:~ p~ ~~~ <br /> <br />ESLIEGCNATRTUIRCEIAN" ' < '.___, _ ~ p?~ COMPANY <br />.~~- PI-~ STATE CERT OR REGIST # e:fZ ({)Ort:./S9! <br /> <br />****************************************************************** <br /> <br />PLUMBER L '" / ' ~ COMPANY ~ '1.J~ <br />SIGNATURE U~A ~ ~ STATE CERT OR REGIST * ~~-ltfd.5 (;0::2. <br /> <br />MECHANICAL *****~~**~:;;**:*********~~~;~~~~6d <br /> <br />SIGNATURE -t:~~ STATE CERT ~ZL <br />***************************************************************** <br />... <br /> <br /> <br />OTHER ~o~ '~ "- <br /> <br />SIGNATURE ~ 0 ~' STATE CERT <br /> <br />COMPANy-Rvrm~~ ~~& <br />OR REGIST # C~ ) 3:1550.5 <br />