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<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION
<br />,
<br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
<br />I' 813-780-0020 FAX: 813-780-0021 /-. '7 V ~() /
<br />DATE RECEIVED _ 'Z- f
<br />
<br />PHONE CONTACT FOR PERMITTING,~ !J-"'J to ~ - ")-7&7
<br />
<br />OWNER'S NAME
<br />
<br />,'-;-' ,
<br />j(;Ao/I
<br />
<br />,;}
<br />l 'y)" "bl R ,,-
<br />
<br />e. R. 54
<br />,
<br />
<br />PHONE
<br />
<br />:;;-/3 -7~8- j-7L. '/
<br />
<br />r
<br />/L. :]") j-4Z
<br />
<br />JOB ADDRESS
<br />
<br />3tf-4r.c(
<br />
<br />E. 7
<br />-- Cc. (.L
<br />
<br />L < /J ~ L/ / A1 -/1 r
<br />I f
<br />
<br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
<br />PARCEL 10 Jj. r: 7 ., Z "I CYJ4u
<br />1t V... - (. 6 - . (- () G It) - ()/;.ltJ - /OBTAIN FROM PROPERTY, TAX NOTICE\
<br />
<br />WORK PROPSED: ~NEW CONSTRUCTION
<br />DSIGN
<br />PROPOSED USE: DSGL FAMILY DWELLING
<br />
<br />)Q COMMERCIAL
<br />
<br />o ADDITION
<br />
<br />o ALTERATION
<br />
<br />o REPAIR
<br />
<br />o INSTALL
<br />
<br />o MOVE
<br />
<br />o DEMOLISH
<br />
<br />DMULTI-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 />
<br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
<br />A I ;/)1) /J .
<br />'./Jr I ,N\ /) ...; ~ L!d. !d
<br />I
<br />
<br />BUILDING SIZE
<br />
<br />SQUARE FOOTAGE
<br />
<br />'/e
<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 />~ BUILDING $ 400:' VALUATION OF TOTAL CONSTRUCTION
<br />0 ELECTRICAL AMP SERVICE 0 Progress Energy 0 W.R.E.C.
<br />0 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 Ji(NO
<br />
<br />1""""""'_'C1"f,"-~_'~~-7~~_~~_""'~"'-~-'--'-' ,~,-.- '-'~-- -- ,,- ".' ".,'-,-.,--...-I-.....-."'....,..'''''-..~_'"'m'''
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<br />
<br />BUILDER
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<br />COMPANY {~.. S j 51
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<br />
<br />SIGNATURE
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<br />.<7 ~
<br />) /7. ,/ ,
<br />j;l//I~ .:' ,/ ~ -> /
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<br />
<br />STATE CERT OR REGIST #
<br />
<br />/.
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<br />ELECTRICIAN
<br />
<br />******************************************************************
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<br />COMPANY
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<br />SIGNATURE
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<br />STATE CERT OR REGIST #
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<br />PLUMBER
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<br />COMPANY
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<br />SIGNATURE
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<br />STATE CERT OR REGIST #
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<br />******************************************************************
<br />
<br />MECHANICAL
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<br />COMPANY
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<br />SIGNATURE
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<br />STATE CERT OR REGIST #
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<br />OTHER
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<br />COMPANY
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<br />SIGNATURE
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<br />STATE CERT OR REGIST #
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