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<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION <br />BUIrING DEPARTMENT 5335 8'1H st, Zephyrhi.lls, FL :33542 <br />813-780-0020 FAX: 813-780-0021 <br />. J DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />\;:2 _1- 0'3 <br /> <br />OWNER'S NAME <br /> <br />tl t Ll 'M ~ ~~ vi f\-tLi'z. ~ (}-1\-~ PHONE <br />~0 c::;. tj I C- To f'L \ 4-,J f.;0 A-<r 7-H- eLLS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID it <br />WORK PROPSED: ONEW CONSTRUCTION <br />DSIGN <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br /> <br />o COMMERCIAL <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />e(IN S TALL <br /> <br />o MOVE <br /> <br />D DEMOLISH <br /> <br />OMULTI - FAMILY <br />o INDUSTRIAL <br /> <br />Oft OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOMI <br />~ OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APrROVAL <br /> <br />11241./ I (p A-r-, C it....) Wk-C~ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <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 PERM~T 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 />~PLUMBING <br />o MECHANICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />$ <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 />~~"',~L ~_~:::::==--,: ~- -~-~:_= ."~.': .,~. ,_._-,.~ .=:_=' ~~':, <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST it <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST i <br /> <br />************************************************~***************** <br /> <br />PLUMBER <br /> <br /> <br />COMPANY -r;;()~') ~lct.~fL f17Al( <a <br />STATE CERT OR REGIST *' DO 'lot/- <br /> <br />SIGNATURE <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 />