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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 STH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:S13-780-0021 <br /> <br />DATE RECEIVED <br /> <br />/-'2'"'/ ~o 0 <br /> <br />-- <br />PHONE GONTACT FOR PERMITTING ~{ <br /> <br />OWNER'S NAME G (ond 1-/6(" Z 01'1 <br />JOB ADDRESS 6 7'10& (J,,/ J. Ave <br /> <br />Lof )90 <br /> <br />PHONE g1/~ - 728 - 54'10 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 # 3LI- 2-';'-2) -O/LJ() -OOODa --19&0 <br /> <br />(OBTAIN FROM PROPERTY.TAX NOTICE) <br /> <br />WORK PROPSED; DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />c;rINSTALL <br /> <br />DSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE; 0 SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />WOBILE HOME <br />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APrROVAL <br />DESCRIPTION OF WQRK Mob de h G 0-\(' _ se -f ~ 4. P <br />BUILDING SIZE 5) X. :2 9 <br /> <br />SQGARE FOOTAGE <br /> <br />/23 q ) <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />NOG <br /> <br />J <br />- <br /> <br />o BUILDING <br /> <br />$ '35060. 0'-' <br /> <br />;' <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o 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 /> <br />BUILDER <br />SIGNATUR~ /~ <br /> <br />COMPANY Bu-fff 1-he1d <br /> <br />STATE CERT OR REGIST # <br /> <br />ELECTRICIAN <br />SIGNATURE IJ~;) ,.::s~ <br /> <br />****************************************************************** <br /> <br /> <br />COMPAt-.L Ace_ _____ <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br />SIGNATURELJ~ /~ ~ <br /> <br />COMPANY 6/Af--terfe(c( MH-..S <br /> <br />STATE CERT OR REGIST # <br /> <br />MECHANICAL <br /> <br />*******************************************}\********************* <br />COMPANY c-e... <br /> <br />SIGNATURE k-!7~~ <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />