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<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION <br />BUIrING DEPARTMENT 5335 8!1!H st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 \ d -7-0 c:s <br />" DATE RECE IVED <br /> <br />PHONE CONTACT FOR PERMITTING <t5 \'3 - -"I \ '-\ - 0537 <br /> <br />OWNER'S NAME ,;1~}f ~ <br />JOB ADDRESS . /)-10 ~ ~ ~ <br /> <br />PHONE <br /> <br />ztJ1 <br /> <br />.3 3Sc{-2- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />/10-210-;;2.-1 -() /I 0- 00000 - 0/30 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION [J ADDITION [JALTERATION o REPAIR o INSTALL <br /> o SIGN o MOVE 0 DEMOLISH <br />PROPOSED USE: OSGL FAMILY DWELLING OMULTI-FAMILY Of OF UNITS o MOBILE HOMI <br /> o COMMERCIAL [J INDUSTRIAL o SWIMMING POOL DOTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APpROVAL <br /> <br />-~ <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 />[J BUILDING <br /> <br />PERMITS REQUESTED <br />5bOb~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />$ <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />[J Progress Energy [J <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />[J MECHANICAL $ <br />[J GAS ~ROOFING [J SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />D FRAME <br /> <br />o STEEL <br /> <br />. 0 OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[J YES [J NO <br /> <br />tL=~=-~~'_-=~~~_~~-=~~~~:~--~-~------~--~-=-:_=-=-' ----- - -~: ~- -:- _: ~- - ~- ~ _:_-~~~~---~~. ~--" <br /> <br />BUIWER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />, <br />STATE CERT OR REGIST f <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 />SIGNATURE <br /> <br />&~~ <br /> <br />********************************************~******************** <br /> <br /> <br />COMPANY ~~A. f<~ <br />STATE CERT OR REGIST '* C. C ~ -0577 Y. "2- <br /> <br />OTHER <br />