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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION
<br />BUILDING DEPARTMENT 5335 BTH St, Zephyrhills, FL 33542
<br />813-780-0020 FAX: 813-7BO-0021
<br />
<br />DATE RECE IVED 3 a '8' -Qt r>
<br />
<br />PHONE CONTACT FOR PERMITTING (8/ ~ 7 I '1- 6 i s' ,
<br />
<br />OWNER'S NAME ~'f ",a,,,,
<br />JOB ADDRESS >'37 Y)
<br />
<br />~,.. .5 ~ /"l.{ c. t 01"\
<br />
<br />, 'l"1 ( .
<br />,
<br />
<br />PHONE (813) 73(.- 0 gz~
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<br />ree" .\.-ku ; '''<;J
<br />LEGAL DESCRIPTION: LOT(S) ~
<br />
<br />l;Jc..u'
<br />I
<br />BLOCK
<br />
<br />..;
<br />,
<br />
<br />SUBDIVISION t~ <:i S It' ~ Vl c t,
<br />(OBTAIN FROM PROPERTY TAX NOTICE)
<br />
<br />PARCEL ID # I Y - '4(P <2 \ -(9 1,0 .' CJOCJO 0 ,- 0 0 90
<br />
<br />WORK PROPSED: PNEW CONSTRUCTION
<br />o SIGN
<br />
<br />PROPOSED USE:~GL FAMILY DWELLING
<br />o COMMERCIAL
<br />
<br />o ADDITION
<br />
<br />DALTERATION
<br />
<br />o RE;PAIR
<br />
<br />o INSTALL
<br />
<br />o MOVE
<br />
<br />o DEMOLISH
<br />
<br />OMULTI-FAMILY
<br />
<br />0# OF UNITS
<br />o SWIMMING POOL
<br />
<br />o MOBILE HOME
<br />o OTHER
<br />
<br />o INDUSTRIAL
<br />
<br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL
<br />DESCRIPTION OF WORK NeuJ S:."I')fe ~^".\y Dt..ve \\'I'IS.
<br />BUILDING SIZE SQUARE FOOTAGE II "-10
<br />
<br />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 />~LDING
<br />~ECTRICAL
<br />~UMBING
<br />~CHANICA/" $
<br />o GAS ~OFING 0 SPECIALTY
<br />TYPE OF CONSTRUCTION: d BLOCK
<br />
<br />PERMITS REQUESTED
<br />
<br />$
<br />
<br />I " 2 ( (900
<br />
<br />.
<br />
<br />d--~O
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />o Progress Energy 0
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANCIAL INSTALLATION
<br />o OTHER
<br />
<br />o FRAME
<br />
<br />o STEEL
<br />
<br />o OTHER
<br />
<br />~O
<br />
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />IS PROJECT IN FLOOD ZONE AREAD YES
<br />
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<br />
<br />SIGNATURE.
<br />
<br />
<br />COMPANY
<br />
<br />R L-:t m Ml C:fYJ~".
<br />
<br />BUILDER
<br />
<br />STATE CERT OR REGIST #
<br />
<br />ELECTRICIAN / ~..,,~~ COMPANY tOJ\+ plLf)cn F\ecmc:..
<br />SIGNATURE .I:>u r v_i:J r---JV STATE CERT OR REGIST *
<br />******************************************************************
<br />
<br />PLUMBER
<br />
<br />
<br />. -
<br />COMPANYj)e.f")~ u.J~
<br />STATE CERT OR REGIST #
<br />
<br />SIGNATURE
<br />
<br />MECHANICAL
<br />
<br />***************************************************
<br />COMPANY ~\ 0l...L--\-\-LlU1../Y'I Curn, .aA
<br />
<br />SIGNf. . . . +.f..............::.~T.E..~E:~,~O;:::~:~S.:::-.~:.~::.-~l
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