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<br />-r 1r33Y~ 04-+- <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8T" St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />l' -30-05 <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />O,"CR', "'"::= [Nt <br /> <br />JOB ADDRESS ( <br /> <br />PHONE qlo-46~-118q <br />3<65d-.d-. A, A..Je.. <br /> <br />PARCEL ID # <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br /> <br />1L/r)1o -C)}- 0010- 0 1=1 00 - 00/0 0 <br /> <br />SUBDIVISION <br /> <br />(OBTATN FROM PROPERTY TAX NOTTCFI <br /> <br />WORK PROPSED: DNEW CONSTRUCTION ~DDITION DALTERATION o REPAIR o INSTALL <br /> DSIGN o MOVE 0 DEMOLISH <br />PROPOSED USE: DSGL FAMILY DWELLING DMULTI-FAMILY 0# OF UNITS [] MOBILE HOME <br /> ~MMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK Jns-fI1J}{)fiOnJt'-l1L[~ ru~J eft1 017 CL 5' X {PI x h II (!onUttfs J:2b. <br /> <br />BUILDING SIZE SQUARE FOOTAGE l~lJ 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 />Ilt"BUILDING <br />lH"ELECTRICAL <br /> <br />$IO,O[()~ <br />$ ~ <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <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 AREAD YES 0 NO <br /> <br />SIGNATURE <br /> <br /> <br />D~Q(R <br /> <br />CO". ' <br />~~' <br /> <br /> <br />COMPANY <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # f6tJ.,08<6'/~ <br /> <br />*****************************~~********************************** <br /> <br />~ h f!.t., it '1',' co",,",- D.)f j lQJ1G (10M ().ei:irtJ I '!df/~. <br />=''::_~-f.J ~ Ct A.t STATE CERT OR REGIST # Ef!./~OO I~O <br /> <br />ELECTRICIAN <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 />