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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhi11s, FL 33542 <br />813-7BO-0020 FAX:B13-7BO-002l <br /> <br />DATE RECE IVED <br /> <br />OWNER'S <br /> <br />NAM~ I is tOY W Mlr10v sIll vvn <br />3g~J.f3 tLfMl. ~ <br /> <br />PHONE CONTACT FOR PERMITTING 5.?-1 - 4-9 "71 <br /> <br />PHONE CgI3)7g~- S 4-1Lj <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />OSIGN <br />PROPOSED USE: ~L FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o ADDITION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br />~LTERATION 0 REPAIR 0 INSTALL <br /> <br />PARCEL 10 # <br /> <br />o MOVE <br /> <br />o 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 />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />thM\-!f ()l.(L /irk S~+W1 <br /> <br />SQUARE FOOTAGE <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <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 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 />o BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <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 />~ECHANICAL <br /> <br />$ <br /> <br />~~q5.00 <br /> <br />VALUATION OF MECHANCIAL INSTALLA'rION <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 /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />********************************************************k********* <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />********************************************************k********* <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />*******************************************Ai**~******j*********** \/ <br /> <br />COMPANY LIlJ::I s I Pr{ G CD Y\4.faA1 f- <br />~ ~ STATE CERT OR REGIST t ~AG05857S" <br /> <br /> <br />***************************************************************** <br /> <br />MECHANICAL <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />