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<br />CITY OF ZEPHYRHILLS PERMIT APPLICA~L'.1UN <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 . ',' ;~-'~i1Ml1' SEP\) <br />DATE ~Cit~ ~4 (",."-,,.', <br />! <\,;36- ~ - t,..", <br />PHONE CONTACT FOR PERMI~rTING 10\\ fre<, <br /> <br />j) rot()tI <br />OWNER'S NAME 1)ou ~~ PHONE 1- 'i?l,'-1f:L'I-te'ltf <br />JOB ADDRESS 3'if1IS/Jindf'/oalRrj Ld 3; :Z-rhr'h.I/sl R.- 3~() . <br />LEGAL DESCRIPTION' LOTIS) 3 BLOCK SUBDIVISION~ Jl,Ik/JI/f12l:. <br />PARCEL 10 # Od. -;;'h-:J...I-tJD/()-tJSf)(J)-003CJ (OBTAIN FRO!-1 PROPERTY TAX NOTICEl <br />WORK PROPSED: ~EW CONSTRUCTION 0 ADDITION OALTERATION 0 REPAIR 0 INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />~ILE HOME <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />R efface V/n'j' Windows ("U1~g Gt~~5) no <br />Jt:J,;{ <br /> <br />6+rI/C+~ cJttuy}<:~.. <br /> <br />DESCRIPTION OF WORK <br /> <br />) ;( j./ " <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 /> <br />~ BUILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ S; 79f' '2J2. <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <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 AREAO YES 0 NO <br /> <br /> <br />BUILDER I1A LA J,,/ ~ -.~ COMPANY <br />SIGNATURE --IAJII'-U"~ qo,- STATE CERT OR REGIST I <br />******************************************************'k*********** <br /> <br />ELECTRICIAN ~ "3'5/ COMPANY Ftrsl- Cj,lS~ Ek-cJ-nc <br />SIGNATURE ~ STATE CERT OR REGIST I <br />******************************************************,k*********** <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 />