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<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION <br />BUIrING DEPARTMENT 5335 B'lH st, Zephyrhills, FL 33542 <br />B13-7BO-0020 FAX:B13-7BO-0021 <br />J DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />\ -\0- CXa <br /> <br />OWNER'S NAME <br /> <br />J!Oli.a (d <br />.j 73S/ <br /> <br /> <br />",,; <br /> <br />() f' fA.>' a /l <br /> <br />tv e-d:J.e t() <<d /22 I v<R . <br /> <br />LEGAL DESCRIPTION: LOT(S) 7/ <br />/~ ~,) & . 02. /-- 0 hl() - cJOOC{)- 07/0 <br /> <br />PHONE <br /> <br />.~~' .~~j~3t3..8f)~.-7',.,:',~:14 <br /> <br />-r cl L <br />lQi .-ree <br /> <br />JOB ADDRESS <br /> <br />BLOCK <br /> <br />SUBDIVISION M dretoOi/ II1(jJ)iJ/, <br />v Ph I t- II <br />{OBTAIN FROM PROPERTY,TAX NOTICEl <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br />o SIGN <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br /> <br />o COMMERCIAL <br /> <br />o ADDITION <br />o MOVE <br /> <br />o ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOMI <br />o OTHER <br /> <br />DESCRIPTION OF WORK SC"L.eX1/ <br />J / I I ':I 1'- I <br />BUILDING SIZE 1. w <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL <br />I"QO/TL '.J (~b <br />,. <br /> <br />SQUARE FOOTAGE <br /> <br />~.~~f <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 PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />tJDC/ <br />~/C~ ./ <br /> <br />~ BUILDING $ II iJlf.rD VALUATION OF TOTAL CONSTRUCTION <br />, <br />ti ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br />o PLUMBING <br />o MECHANICAL $ VALUATION OF MECHANCIAL INSTALLATION <br />o GAS o ROOFING o SPECIALTY 0 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 />l'I,-'~"-"T'-'" ",.. ...-.-.--'"')' .-'"'' . i'" ,---,-----.-. ---- --..,,' ~ ,. --',' -T' -'--:-"-~', <br />I I \. 1 f , f, ' <br />~~~_~__.~___________~"'--"-___l....___~~_._~_~._______ ----------- ---- --- - ~ -----------~--------~- " <br /> <br />BUILDER _ I . <br />SIGNA;URE ,S (La i,- (P'L(( <br /> <br />1 ; .\~-> <br /> <br />COMPANY <br /> <br />I3tt II I" IJ AU-<.fl (/)t!fYl <br /> <br />0- <br />:DCif <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />~-...~ <br /> <br />'1') 1-' <br /> <br />COMPANY <br /> <br />IOf. C lfi,f J <br /> <br />E&cl/'tt- <br /> <br />" <br /> <br />ELECTRICIAN ) / j <br />SIGNATURE ~S(j d. i__ ~\./l <br />(/ <br /> <br />- <br />STATE CERT OR REGIST # <br /> <br />PLUMBER <br /> <br />********************************~~~~************.***************** <br />'- '-\ ~~/'" <br />~, COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR ~EGIST # <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 i <br />