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<br />.. <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8D St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />PHONE CONTACT FOR <br /> <br />L q /"'" <br />DATE RECE IWD Id-l&: 10":) <br />PASCO p~RMlr S~RlflCE:: <br />PERMITTING I-~w(q- g~z.t ~ 78 <1lf <br /> <br />OWNER'S NAME <br /> <br /><.SftJ Ii f1 f C'I/.'1 t' /1 <br /> <br />- <br /> <br />,3 fr 'I c; au tl-il z ~ <br />r;L <br />;; '/ -~ fR - rJ/ '-" () r>> () I '- 0J<ll)- OOY 0 <br /> <br />PHONE <br /> <br />JOB .ADDRESS <br /> <br />SUBDIVISION T,0 E/Urtl./I ~()I^k <br />/{j! 4 J"O /1 f // ,tA.1ie.. / <br />(OBTAIN FROM PROPF.RTY TAX NOTICE) <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br />OSIGN <br /> <br />o ADDITION <br />o MOVE <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <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 />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br />I <br />BUILDING SIZE /J... X iJ3 <br />7 'x IV I <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 />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />~ /&cI, NOm 41/ ilr/!A - q Iff;/) /()()hJ 04.1/~ ~~i <br /> <br />/ SQUARE FOOTA~~ (PI'! t /' HEIGHT <br /> <br />PERMITS REQUESTED <br /> <br />JJoL - <br />~\'(U'-:L- ~ <br />i.--\ r - SUb~~\ \ ~~i <br />- rz..{t016 <br /> <br />'it BUILDING <br />~LECTRICAL <br /> <br />$ <br /> <br />3S' I3S- <br />J <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />'t:f PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <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 />SIGNATURE <br /> <br />~'(l ~ ~Il <br /> <br />".-._.. . <br />€ONmRAemoR SECT:EOlJ <br />? I'::. ~:.::. DU-1 <br />7 / COMPANY <br /> <br /> <br />(;Lh. IJ...-(! . <br /> <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # <br /> <br />-M! <br /> <br />( <br /> <br /> <br />**********~~******************************************** <br /> <br /> <br />'- ' ;({'" /15: ~~ COMPANY J/}{),../oll !I.~{lII'ic <br /> <br />- <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />PLUMBER <br /> <br />~c:.tz~ k!L 1:J~~'> ~ <br />{j ;v <br /> <br />COMPANY <br /> <br />;2t Ie )Zt(i.p I~ <br /> <br />.//.............-....\.. <br />. . <br /> <br /> <br />o. <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />-- <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 />