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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTM:E:NT 5335 a'xfI St, Zephyrhills, FL 33542 <br />in ]--7 80-002 0 lI'AX: 813-780-0021 <br /> <br />PHONE CONTACT FOR <br /> <br />DATE: RECEIVED / -/P- db <br /> <br />PERMI'rTING 813- 7&-t;,'1'fo <br />ley,' <br /> <br />OWNER'S NAME Grond <br />JOB ADDRESS :3125 () <br /> <br />~I 0 n 2 un WI IY\e.) I I h G <br />IV eulu(Yi~J ve [0 -; 267 <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # <br /> <br />3t.f-25-'2/-D176 -D6000- 2070 <br /> <br />(OBTA IN FRm1 PROPERTY TAX NOTICE) <br /> <br />~'i1ORK PROPS ED : DNEW CONSTRUCTION <br /> <br />DADDITION <br /> <br />DALTERATION <br /> <br />D REPAIR <br /> <br />rsvfNSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />~BILE HOME <br />o OTHER <br /> <br />D RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WQRK s~t-U.p 0-+ )-,v1()h)~aV7"\ e. <br />BUILDING SIZ~Ct,x 2- 7 _SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />o BUILDING <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLA~S & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.i-I;:?-()b r' <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. c.../~VH-aJeJl oi9J? 't- <br />PROPERTY SURVEY REQIJIRED FOR ALL NEW CONSTRUCTION. j l~~.'~ a1.k f::! <br /> <br />;fht'~5~ U ~$r;gz <br /> <br />(I/'~' ,~~~ <br /> <br />tJOC-/ <br /> <br />VALUATION OF TOTAL CONSTRUCTION W. mQ..\:t:x. _ <br />~ C\..J...J\.C.(. ,/ <br />W.R.E.C. - <br /> <br />PERMITS REQUESTED <br />'35/)00. ~;" <br /> <br />$ <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy <br /> <br />o <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLll.TION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />[J OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />IJ FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE; AREAD YES <br /> <br />o NO <br /> <br /> <br />BUILDER <br />SIGNATURE0~~ <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN ~ <br />SIGNATURE 4J~ /1dL <br /> <br />COMPANY Ace.. <br /> <br />@) <br /> <br />STATE CERT OR REGIST # <br /> <br />*********************'k******************************************** <br /> <br />PLUMBER <br /> <br />COMPANY 13l( fic,;(;d.. (-I.... <br /> <br />@- <br /> <br />SIGNATURE~ ~~ <br /> <br />*********************~;*********~********************************** <br />COMPANY Ace <br /> <br />STATE CERT OR REGIST # <br /> <br />-rP <br /> <br />MECHANICAL <br /> <br />SIGNATUREh~ /7 -<' ~'J STATE CERT OR REGIST # <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />