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<br />CIrry OF :liJ!i.t'n~nn..L.u.LIu ... ..........- - --- --- <br />BUIILDING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542 <br />813-780-0020 FAX:B13-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE GONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />~-fj; ~e./JA C~c clc t<r.e:-h PHONE <br />I ~A <br />-;:f? 710 .s ~~ <br /> <br />;7 E':;( ~ t:Z-ff / 5 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 10 it \ \ -d.l.o - d \ - 00\ 0- II \ 00'- ()OIO <br /> <br />IOBTAIN FROM PROPERTY.TAX NOTICE\ <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />D SIGN <br /> <br />o ADDITION <br /> <br />o ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DMOVE <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />O. OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HO~ <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL <br /> <br />/,1 y.,.. ~Ce!f;~rC%<<:~ ~ <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE 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 />D BUILDING <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D ELECTRICAL <br />D PLUMBING <br />~Al'lICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />1~oo <br /> <br />VALUATION OF-MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />D STEEL <br /> <br />'D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES D NO <br /> <br />~--'~"__ -- - - -,- .--- ,"- . - ."- 1-- ~-~--_.------- . .. ' ' - - - --- -..- --- -~,--- <br /> <br />I t t I I I 1.1 1'1 <br />, I I , I ~', J I r I 'J ' fr III <br /> <br />~~~_.;..;....J.~_.-......-~J___~~_'- - ---.-----.!.------------ --~ ---~.-~~~~--~ <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST i <br /> <br />****************************************************************** <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 />SIGNATURE <br /> <br /> <br />COMPANY <br /> <br /> <br />~ <br /> <br />******************************************** <br /> <br />MECHANICAL <br /> <br />STATE CERT <br /> <br />**********************.********~****~*************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />