|
<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION
<br />BUI!LDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
<br />I 813-780-0020 FAX: 813-780-0021 1- '31'O~
<br />DATE RECEIVED
<br />
<br />I PHONE CONTACT FOR PERMITTING
<br />
<br />OWNER'S NAME
<br />
<br />M a.o('y R.
<br />(0131 li"tb
<br />
<br />Burdin
<br />6t.
<br />
<br />PHONE
<br />
<br />JOB ADDRESS
<br />
<br />LEGAL DESCRIPTION: LOT(S)
<br />
<br />BLOCK
<br />
<br />SUBDIVISION
<br />
<br />PARCEL 10 #
<br />
<br />02- '2(0 -'2)- 0180 -00000 -02'20 (OBTAIN FROM PROPERTYTAX NOTICE)
<br />
<br />WORK PROPSED: DNEW CONSTRUCTION
<br />DSIGN
<br />
<br />PROPOSED USE: DSGL FAMILY DWELLING
<br />o COMMERCIAL
<br />
<br />D ADDITION
<br />
<br />o ALTERATION
<br />
<br />D REPAIR
<br />
<br />D INSTALL
<br />
<br />o MOVE
<br />
<br />o DEMOLISH
<br />
<br />OMULTI-FAMILY
<br />D INDUSTRIAL
<br />
<br />D# OF UNITS
<br />o SWIMMING POOL
<br />
<br />D MOBILE HOMI
<br />D OTHER
<br />
<br />DESCRIPTION OF WORK
<br />
<br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL
<br />
<br />R-~-tcso~
<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 />o BUILDING
<br />
<br />$ 3850
<br />
<br />00
<br />-
<br />
<br />VALWATION OF TOTAL CONSTRUCTION
<br />
<br />o ELECTRICAL
<br />o PLUMBING
<br />D MECHANICAL $
<br />D GAS ~OOFING D SPECIALTY
<br />
<br />AMP SERVICE
<br />
<br />o Progress Energy 0
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANCIAL INSTALLATION
<br />
<br />D OTHER
<br />
<br />TYPE OF CONSTRUCTION: D BLOCK
<br />
<br />D FRAME
<br />
<br />D STEEL
<br />
<br />D OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO
<br />
<br />'-"",',:-~"T.',--,,,,~ - -":---,---,'I"f-- ,,' "";"", "",'" ---~,-------- -- ," ,," i '-', '~' ".--,"IT-I-'~~I,pJ~l'p,':
<br />111:",[" 'I,,,, '", """ "," , ' I,',' "",,?'1;,f~,d,h
<br />r!.L~~~~':.:',~~___,-'~.:-'_":_'~:':L::,..!.'- _~_"....:___~______,__,__ __~ ~_..:.....!_~_':"'-~!..... I, I 1.1'1,']:,1,
<br />
<br />SIGNATURE
<br />
<br />'/J COMPANY '\'lood C0'1~f'rlJ(..lf'1 ~l\l
<br />
<br />
<br />~ d ~ STATE CERT OR REGIST #
<br />
<br />* * * * *** ******'** * * * ~* * * * * * ** * * ***** ** *** ** ******** * ***** ****
<br />
<br />~ a~l~
<br />
<br />BUILDER
<br />
<br />ELECTRICIAN
<br />
<br />COMPANY
<br />
<br />SIGNATURE
<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 />******************************************************************
<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 #
<br />
|