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<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION <br />BUI;LDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DA'I'E RECEIVED <br /> <br />\d- \a-05 <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />...--,-- <br />OWNER'S NAME / () jY\ Cl >- L <br />JOB ADDRESS 5"" / / (-P 7V4t <br />, <br /> <br />S. 5e_d / ~, J< <br />:;-h'e L J- <br /> <br />PHONE: 2/:3 ~ 5-C;- ?? '11 <br /> <br />SUBDIVISION <br />o~~O (OBTAIN FROM PROPERTY.TAX NOTICEl <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID #' <br /> <br />) / "). 4: ,;? I <br /> <br />!PolO <br />I <br /> <br />/e; ..) (1) <br /> <br />WORK PROPSED: [JNEW CONSTRUCTION <br />DSIGN <br /> <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />[JADDITION <br /> <br />[JALTERATION <br /> <br />o REPAIR <br /> <br />[] INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />[JMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J#, OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOM <br />[J OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APpROVAL <br />DESCRIPTION OF WORK~e~ If) r;+ <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 PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br /> PERMITS REQUESTED <br />[] BUILDING $ <..:;) , () b 0 VALUATION OF TOTAL CONSTRUCTION <br /> , <br />0 ELECTRICAL AMP SERVICE [] Progress Energy 0 W.R.E.C. <br />[] PLUMBING <br />[J MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION <br />[J GAS [J ROOFING [J SPECIALTY [J OTHER <br /> <br />TYPE OF CONSTRUCTION: [J BLOCK <br /> <br />[J FRAME <br /> <br />[J STEEL <br /> <br />[J OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES [] NO <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE 5(~~ {IDJ11C1~7 <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST #' <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <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 />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />