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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />~UILDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 . I f <br />6Sllf DATE RECEIVED -1J \'\_6" <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME Ke.-.J"I'L ~ <br />JOB ADDRESS_f)'6~R--cit s:+. <br /> <br />PHONE gr3 - 7?.;t-O<P~ <br /> <br />..) .:... <br />. . <br /> <br />LEGAL DESCRI PTION: LOT (S) O...:l.J' D BLOCK tO/L/'oO <br />PARCEL ID # II -::L0 ~ - BCYO -Ole/OJ. ().;;;1/f) <br /> <br />SUBDIVISION <br /> <br />c-o / C> <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />. WORK PROPSED: 1d1:iEw CONSTRUCTIO~ <br />o SIGN <br /> <br />o ADDITION <br /> <br />DALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br /> <br />o MOVE 0 DEMOLISH <br />BMU~~~ 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 />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK h ~ D~~ . <br />BUILDING SIZE 3D)C &'cf.1 P tl' SQUARE FOOTAGE I~ 7'9' <br /> <br />HEIGHT <br /> <br />~ <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL:. A.TTACH (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 />. ~J~ QyL ~ ~ /(P79~<f~? <br />PERMITS REQUESTED <br /> <br />IIYBUILDING <br />~ECTRICAL <br />~UMBING <br />~CHANICAL <br />o GAS ~FING <br /> <br />$ I r~c>~ VALUATION OF TOTAL CONSTRUCTION' <br /> <br />c;;<~ . AMP SERVICE 0 Progress Energy 0 W.R.E.C. <br /> <br />$ &,/OeD..-OD 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 AREAD YES ~ <br /> <br /> <br />BUILDER <br /> <br />SIGNAT~E <br /> <br />STATE CERT OR REGIST # (!...g~ asS-Is sP <br />, <br /> <br />******************************************************** <br /> <br />:::::::~cfr :::::N:::::::: . r~co /3<P!S <br /> <br /> <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br /> <br />COMPANy.0~ W~ <br />STATE CERT OR REGIST # c.....~ 'IL/Q. S" toO ::>- <br /> <br />SIGNATUR.E <br /> <br />MECJlANICAL ~6U J :- \.-P ~ A/ <br />SIGNATURE(--7~t7~ j~r r STATE CERT OR <br /> <br /> <br />* ~ *.* * ~ ~ * * *.* *.* * * *~ * * * * * ** * * * * ** * ** * ** ~-* *:..n***;..~* * ** *D.... * ~ * .... <br /> <br /> <br />OTHER--R~"~~PAN~ <br />SIGNATURE iJ-b--t.-"' '. STATE CERT ;~ ~~GIST'~ ~ ~ /6;1.5 S't)~ <br /> <br />. COMPANY <br />