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<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION <br />BUIrING DEPARTMENT 5335 8u st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 ! 1 10./05 <br />J DATE RECEIVED ~~~- -- <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME ~. _~ ~J:~n'~~ f{ I ~,~ . <br />JOB ADDRESS . ,.~,,'3. _~_^ ,-;iT'~e--f. <br />LEGAL DESCRIPTION: LOT (S) y. <lj-a +~, BLOCK 12 Lj SUBDIVISION C}y Z')U H S <br />PARCEL ID 'It /) .2;';;;;'2.} \~;:'<J u? J/?'~~l::? rJO~CJ (OBTAIN FROM PROPERTY. TAX NOTICE\ <br />WORK PROPSED: ONEW CONSTRUCTION 0 ADDITION r.(ALTERATION 0 REPAIR 0 INSTALL <br /> <br />PHONE <br /> <br />;;;~j..?Y - ~~i~4~ <br /> <br />o SIGN <br />PROPOSED USE: ~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />D. OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOMI <br />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APfROVAL <br />DESCRIPTION OF WORK P-rz/:. )O""'-~ .J. 5' jAr- ''3 S E re~..iY=r..{ -\ n y-c-!.')[,YT\ <br /> <br />BUILDING SIZE SQUARE FOOTAGE 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 />[] ELECTRICAL <br />o 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 AREAD YES 0 NO <br /> <br /> <br />,~ ~ <br />BUIIDER /,1' COMPANY <br />! >' - <br />. , ,'. v <br />SIGNATUREl >(.tL-<7Yr)~4/ ; ~-J STATE CERT <br />/ <br />" <br />, <br />C <br /> <br />r- <br /> <br />OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />- <br />STATE CERT OR REGIST . <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST 'It <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST t <br /> <br />********************************************~******************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST t <br />