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<br />CI~Y OF ZEPHYRHILLS PERMLT A~~~~~A~~U~ <br />BUnDING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />L\ f? 10<0 <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME <br /> <br />,~. l,) ,~... \ <br /> <br />{\' u.. ." <br /> <br />PHONE f)"3 - .~" :<. - ;;. vI ~ y <br /> <br />JOB ADDRESS <br /> <br />t; (J ',), r.~ <br /> <br />. ;,.;' <br />\ " l !) ~ <br /> <br />-,. <br />< " <br /> <br />) ~\,\ <br />. <br /> <br />~" . <br /> <br />',) <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # \\ -rl.~-d \- f)O\t:>- &\300 - 0 \ \ 0 <br /> <br />(OBTAIN FROM PROPERTY.TAX NOTICE) <br /> <br />WORK PROPSED: []NEW CONSTRUCTION o ADDITION o ALTERATION o REPAIR I2rINSTALL <br /> o SIGN o MOVE 0 DEMOLISH <br />PROPOSED USE: OSGL FAMILY DWELLING OMULTI-FAMILY 0# OF UNITS o MOBILE HOt-' <br /> o COMMERCIAL o INDUSTRIAL o SWIMMING POOL 12I0THER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APfROVAL <br /> <br />Plumb" iI~ ~e..0--.'J -\0 ~-5\<:~\Q - (!cmn ~ecJcliO\ ~ <br /> <br />DESCRIPTION OF WORK j}.\)\) <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <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 PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />D BUILDING <br /> <br />$ ::)00 I (::X:) <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />~ PLUMBING <br />o MECHA~ICAL <br /> <br />AMP SERVICE <br /> <br />D Progress Energy D <br /> <br />W.R.E.C. <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 AREAD YES 0 NO <br /> <br />'~lr~I--"..-...--t-..~,.. __ _ _ ___..______ ~,_~ _ ~._.. _ _ . ,~_ ~__~,..............~~_~_____ ---~--~ ~ - .. - -- - -.. ---.. -, ~._~- --,.."e-r;-"""'" <br />I,,' , i I' I:' , I , I,. ,I:' .T"I ,I il <br />L"_~.-.:.....~- ____.-..:......~_..'_,~.___'_ ___._.__L___~---,-, _ --~-~~~~-~~ "'. [', <br /> <br />SIGNATURE <br /> <br />..~ <br /> <br />COMPANY t-! 0 ...11\.. e Ou..; y\. ~ -R- <br /> <br />BUILDER <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />- <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <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 i <br />