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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TK St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE GONTACT FOR PERMITTIN~' <br /> <br />b\ \/ <br />199-51io <br /> <br />~J()(}zon <br /> <br />L Or&:i LeiAJiJ AV0 <br /> <br />LEGAL DESCRIPTION: LOT(S) U BLOCK <br />PARCEL 10 # 3'1-25-21' or1) - C)oo<s 0 - '2220 <br /> <br />OWNER'S NAME () t' (j fJc! <br />JOB ADDRESS 3 -; it; Z~ <br /> <br />6i) PHONE <br /> <br />g/3- 78g9(I./O <br /> <br />L,,1222 <br /> <br />SUBDIVISION <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />(OBTAIN FROM PROPERTY.TAX NOTICE) <br />DALTERATION 0 REPAIR ~STALL <br /> <br />OSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: 0 SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />OMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />o jl OF UNITS <br />o SWIMMING POOL <br /> <br />~ILE HOME <br />o OTHER <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APfROVAL <br /> <br />DESCRIPTION OF WORK }nO bl /e h cyriL 5e-l - i1p <br /> <br />BUILDING SIZE Z lKY7SQGJARE FOOTAGE <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 />HEIGHT <br /> <br />li~/'BUILDING <br /> <br />PERMITS REQUESTED <br /> <br />$ 30l::~O_C'~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W,R.E,C, <br /> <br />o PLUt-'lBING <br />o MECHANICAL <br /> <br />$ <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 />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES 0 NO <br /> <br /> <br />BUILDER COMPANY <br />SIGNATURE ~c.L~ STATE CERT OR REGIST # <br />Jr ~~**:*::~~*:************************************************* <br />E~ECTRICIAN COMPANy;1c~ <br />SIGNATURE tZ ~A..., ~ STATE :ERT :OR REGIST I <br /> <br />( b.,.,rt,rCe.. <br />.~ ..".9 <br />2~D.....,><~ <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br />~~ <br /> <br />COMPANY B ~<.-f-1c./-hd ,d <br /> <br />tv1H r <br /> <br />~ <br /> <br />PLUMBER <br /> <br />STATE CERT OR REGIST jl <br /> <br />* * * * * * * * * * * * * * * * * * * * * * * * * * -k 10..- * -k * * * * * * * * * * * * * 1r *. * * * * * * * * * * * * * * * * * * *.* <br />MECHANICAL COMPANY f1( 0 <br /> <br />SIGNATURE ~~ STATE CE~T OR REGIST ff <br /> <br />@ <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />