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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />/ <br />2,( iP(6(P <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />Le tv N e.,\ \v\o 1M, C-~ <br />7550 wterv'^-~h>:\l(. c,l.rcl€ <br /> <br />b~ <br />3> ~ -doC;; ~ ;). t - Ol).o'- ax;oo <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION Q(clUl~W' <br />-oGSu (OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />l-l~ ~ ls <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: 0 NEW CONSTRUCTION <br /> <br />DADDITION <br /> <br />DALTERATION <br /> <br />D REPAIR <br /> <br />-B-:rNSTALL <br /> <br />D SIGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />D MOVE <br /> <br />D DEMOLISH <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />D# 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 /> <br />5 fr It-J~ ~ <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 />D BUILDING $ I (5l5t>. oD VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL AMP SERVICE D Progress Energy D W.R.E.C. <br />PPLUMBING <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 />D STEEL <br /> <br />D OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />~~ <br /> <br />" <br /> <br />J -- I <br />COMPANY \At ~l \.Vot,J :J:---[fI J' <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <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 />