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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8B st, Zephyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br />PASCO PERMlI Sf:RIfICE <br />PHONE CONTACT FOR PERMITTING l-cg{q~-g~Lf-7g9a.f <br /> <br />/.:2- l-t'F <br /> <br />OWNER'S NAME <br /> <br />10m <br /> <br />6t1.. rb / tL/J <br />At u. a./Il fU.t/..e. totly <br />lif <br />.J- If - ,j..{, - J-/ - ()() cJ..O - 0 ()(JQJ - () / va <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />JS/~ <br /> <br />SUBDIVISION/it E~IIb,;k R.I' <br />&drf <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br />OSIGN <br /> <br />o ADDITION <br />o MOVE <br /> <br />o ALTERAT ION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE:~GL 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 />DESCRIPTION OF WORK <br />III ( <br /> <br />BUILDING SIZE <br /> <br />CJ RES TAURANT <br />(t Q.. r po r I <br />It Yl/ I <br /> <br />& HEALTH DEPARTMENT APPROVAL <br />1/1 e K/jl \SU <br />/ HI <br />SQUARE FOOTAGE 14' fI <br /> <br />HEIGHT <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 ENERiGY' FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTIO /) _~ <br />L'1/, :) <br /> <br />$ <br /> <br />~ 7&2.0.oU <br />, <br /> <br />PERMITS REQUESTED <br /> <br />r:j. BUILDING <br />o ELECTRICAL <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <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 />BUILDER <br /> <br />eONmiAemR' SECTiON <br />COMPANY !uA.. tv;&, c()MlItJ.(!I-/.b~ <br /> <br />SIGNATURE <br /> <br />~ 4~ ;r-IC <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 />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />