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<br />CIrY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUI;LDING DEPARTMENT 5335 BTH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-7BO-0021 <br />DA,]~E RECEIVED 12-2t'~CJS <br /> <br />PHONE CONTACT FOR PERMITTING 7~2- .For:1 <br /> <br />OWNER'S NAME <br /> <br />()oA'~ <br /> <br />L~o(,co <br />j1' j, ~V[ <br /> <br />PHONE~ <br /> <br />782- 7'/.5- Y <br />. <br /> <br />JOB ADDRESS . '3 t? 70 t <br /> <br />Z-I(,,//..5 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br />WORK PROPSED: [JNEW CONSTRUCTION <br />Os I GN <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />/OBTAIN FROM PROPERTY,TAX NOTICE) <br /> <br />[JADDITION <br /> <br />[JALTERATION <br /> <br />o REPAIR <br /> <br />~NSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-FAMILY <br />[J INDUSTRIAL <br /> <br />[J# OF UNITS <br />[J SWIMMING POOL <br /> <br />[J MOBILE HOM <br />D OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />;t~~ <br /> <br />A/c V/L//' r <br />, <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 /> <br />[] BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ,.....---- -'" ,'., <br />0 ELECTRICAL AMP SERVICE 0 Progress Energy ~W.R.E.C. \ <br />[] PLUMBING l/.: a g! <br />~CHANICAL 36oo,~D <br />$ VALUATION OF MECHANCIAL INSTA TI . <br />o GAS o ROOFING o SPECIALTY [J OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />[J FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br />~1'1~i'~~W:-'~~' ~- ._";:-,~_._-;._'_.- ". '".'" ., "(-'- ._--~-_. .. --.- i'''''''' i, .. . ,'" -" ~",',"-~",--;:--'T;~r;;;; <br />j'i I I I I ! I I r I 1): I' , I' I I . ~ I I . 'I I 1,,':;- f~l; / ~pil! <br />I,r 1 , I It! r I ~ T, IT' , I I, I . j'! I , I r ' j! I' <br />~...............~~__"'-'l-_j~...._~""~___J.....;._,_~__~_____-~----- - -~-~~~~-~-~~ <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT 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 # <br /> <br />SIGNATURE <br /> <br />;/'(/4 <br /> <br /> <br />*~:********************************************~**************** <br /> <br />****************************************************************** <br />COMPANY 44#/2 ~ flb?/-f,vf 6rlJ e.~ <br /> <br />STATE CERT OR REGIST # CA~~ j1.19' Y &' <br /> <br />MECHANICAL <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />