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<br />.. . <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8T11 St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED :>- , - 0 Co <br />PASCO P~RMll SE'RII'ICE <br />PHONE CONTACT FOR PERMITTING 1-'6(q(q-'B?z.t-7'B9tJ <br /> <br />OWNER'S NAME <br /> <br />Lt'/) rk <br />,)"S- tXJ <br /> <br />YeLl) A/~11 <br />/0-11.. S/Ul f <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT (S) /3 ~ Ir BLOCK /If <br />PARCEL ID # 11- '2!0- 21 - CO, 0 - \\)<00 - 0 \'?~o <br /> <br />SUBDIVISIONM.v? of Z~rk"ll;{' <br /> <br />(OBTAIN FROM PROPF.RTY TAX NOTICE) <br /> <br />WORK PROPSED: ~NEW CONSTRUCTION <br />DSIGN <br /> <br />D ADDITION <br /> <br />DALTERATION <br />D DEMOLISH <br /> <br />D REPAIR <br /> <br />D INSTALL <br /> <br />D MOVE <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />D COMMERCIAL <br /> <br />DMULTI-FAMILY <br />D INDUSTRIAL <br /> <br />D# OF UNITS <br />D SWIMMING POOL <br /> <br />D MOBILE HOME <br />D OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />CJ RESTAURANT & HEALTH <br />/~ro/J_AcI <br /> <br />DEPARTMENT APPROVAL <br />10M / +- ..AZ. /L~ / ().f b~ , <br />S;UARE FOOTAGE tP y{p 'f &;>rJ./t <br /> <br />HEIGHT <br /> <br />BUILDING SIZE <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 />.~ BUILDING <br />bIi.. ELECTRICAL <br /> <br />$ <br /> <br />19 <br />~1 97S'. <br />, <br /> <br />PERMITS REQUESTED <br /> <br />p f E" R.LLw ~Q. <br />t-J 0 C- <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D FLORIDA POWER <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />\'( PLUMBING <br />D MECHANICAL <br /> <br />$ <br /> <br />D GAS <br /> <br />D ROOFING <br /> <br />D SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <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 AREAD YES D NO <br /> <br />I <br /> <br />~~t~ <br /> <br />.. ...'..- ..-....-.. '-...---.....--. ,.- .'. ~..' '"'' .....". . - ..~.,.., . '. '.-..., '"." <br />~~~"Y.$J:9'D(!:01i <br />~ '"' 7T/J <br />1;70.'''';''-' COMPANY <br />el]HJ.L- <br /> <br />/WI C~Jracli/2) @ <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />ELECTRICIAN ~ . <br />SIGNATURE t.S &... e U:. <br /> <br />****************************************************************** <br /> <br />COMPANY ;){UU/ct/tF [&(Iri~ <br /> <br />C/~bVL ~)'.. ~~ <br /> <br />@W <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />~f/a_~ <br /> <br />- .,~ <br /> <br />1)..~ <br />C~ <br /> <br />COMPANY <br /> <br />VT/3 <br /> <br />PM/ toA-/~I('jill~ (i0 <br />./ <br /> <br />PLUMBER <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 />