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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />i BUILDING DEPARTMENT 5335 9~R at, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 \ J I a ID/- <br />0~ '? DATE RECE IVED - - .:J - ~ <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME K~o.Jil'\.. ~ <br />JOB ADD~~Lf~s<f'4d' ,R-cIt ~+. (N) <br /> <br />PHONE ~r:5 - 7J>;t-O?~ <br /> <br /><oJ ... <br />, . <br /> <br />LEGAL DESCRI PT I ON: LOT (S ) O~ D BLOCK <Of '-{'oD <br />PARCEL ID # II -:;1..10 ~ _ ec;yO -Of'l'c:O ~ ().;1./[) <br /> <br />SUBDIVISION <br /> <br />0-0/ C> <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~W CONSTRUCTIO~ <br />OSIGN <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br /> <br />o MOVE 0 DEMOLISH <br />EtMUJ1~~ 0# OF UNITS <br /> <br />o COMMERCIAL <br /> <br />o INDUSTRIAL <br /> <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIPTION OF WORK n ~ <br />BUILDING SIZE 3DX (pcf.I'p q- <br />. <br /> <br />o RESTAURANT & HEALTH DEPARTMEN1VVAL f) ...-.'1 <br /> <br />b~fB;c ~ <br /> <br />SQUARE FOOTAGE /&179 HEIGHT ~ <br /> <br />I1YBUILDING <br />~ECTRICAL <br />~UMBING <br />~CHANICAL <br />o GAS ~FING <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. r:\ <br /> <br />. +>J~ QyL ~ 4 /079~<-f~~ <br />PERMITS REQUESTED <br />$~u!!r~.~ VALUATION OF TOTAL CONSTRUCTION <br />" <br /> <br />~f{;;f) . AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br /> <br />$ ~ /()€)€).<02> VALUATION OF MECHANCIAL INSTALLATION <br />o SPECIALTY 0 OTHER <br /> <br />TYPE OF CONSTRUCTION~LOCK <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 ~ <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # C!-~ OSS"/Sf <br /> <br />COMPANyTh a I Kd' <br /> <br />e~ <br /># C c.. j3CO 1.sc:P.s <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST <br /> <br />****************************************************** <br /> <br />PLUMBER <br /> <br /> <br />')- <br /> <br />COMPAN~ W~ <br />STATE CERT OR REGIST # c..,~ . ft-/-Q. S" toO :::l.-.- <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />. COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR <br /> <br />OT~R~~~ <br />SIGNATURE .' ,tA..l) <br />\ <br /> <br />. ****....~~w::~:~~~ <br /> <br />t/fA STATE CERT OR REGIST * ~ /3;;{5"s-~ <br />