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<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION
<br />BUI'LDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542
<br />813-780-0020 FAX: 813-780-0021 '--\ '-\ _ 00
<br />DATE RECEIVED -\
<br />
<br />~~i'r(Nlqo p-
<br />OWNER'S NAME U ~ /10 tJJ G"
<br />
<br />PHONE CONTACT FOR PERMITTING (8/3) 690 -18 8S'
<br />
<br />ChtPO(l/f r/ 0 r/ - Le -1/,// AIZ..
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<br />
<br />PHONE
<br />
<br />81~ - ?t,9 - 5"..;)'7'7
<br />
<br />JOB ADDRESS UM~
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<br />QPt(ZAL'i" (2(",~
<br />
<br />LEGAL DESCRIPTION: LOT (S) BLOCK SUBDIVISION !:it-Hr/P ~tt'j:. "';~"II1IHol11?.s
<br />PARCEL 10 # D:O '"J-.G - d 1- SSSS -():::ooO ~~ OIL./- 0 (OBTAIN FROM PROPERTY, TAX NOTICE)
<br />
<br />WORK PROPSED: )d'NEW CONSTRUCTION
<br />DSIGN
<br />PROPOSED USE: (JSGL FAMILY DWELLING
<br />(J COMMERCIAL
<br />
<br />(JADDITION
<br />
<br />(J ALTERATION
<br />
<br />(J REPAIR
<br />
<br />(J INSTALL
<br />
<br />D MOVE
<br />
<br />''I'5li 'Tow,v+lo.'"r\E-S
<br />,......MYL'i'I PM1HY
<br />
<br />D DEMOLISH
<br />
<br />(J INDUSTRIAL
<br />
<br />(J# OF UNITS
<br />(J SWIMMING POOL
<br />
<br />(J MOBILE HOM
<br />(JOTHER
<br />
<br />c:J RESTAURANT & HEALTH DEPARTMENT APrROVAL
<br />DESCRIPTION OF WORK "/0 W,VfjOmF!
<br />BUI-;rf~~ZE /2fo,S'K G3.3/
<br />
<br />SQUARE FOOTAGE
<br />
<br />/ ~/ ~'I0
<br />
<br />HEIGHT ;)1 r
<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 />
<br />PERMITS REQUESTED
<br />$.-3.fp II <gr (, 00 VAL~ATION OF TOTAL CONSTRUCTION
<br />AMP SERVICE 00 Progress Energy D
<br />
<br />W.R.E.C.
<br />
<br />[] ELECTRICAL
<br />D PLUMBING
<br />o MECHANICAL
<br />
<br />$
<br />
<br />33/ poO
<br />,
<br />
<br />(0 1in... '* L I (j VNI1-.S
<br />VALUATION OF'MECHANCIAL INSTALLATION
<br />
<br />(J OTHER
<br />
<br />o GAS
<br />
<br />o ROOFING
<br />
<br />o SPECIALTY
<br />
<br />TYPE OF CONSTRUCTION: OJ BLOCK
<br />
<br />(J FRAME
<br />
<br />(J STEEL
<br />
<br />(J OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />IS PROJECT IN FLOOD ZONE AREA(J YES (J NO
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<br />COMPANY tiS' #0,""1: C~I"(-r-LEN/V/I/Z-
<br />STATE CERT OR REGIST # CB C I ;; 5::2 <.; :2 0
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<br />******************************************************************
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<br />ELECTRICI~ ~ ~
<br />SIGNATURE ~
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<br />COMPANY .:TI3C CUFC'''~/ ~ ()~ -Mm,JO/I
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<br />STATE CERT OR REGIST # [C /300 I B 8 b
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<br />******************************************************************
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<br />PLOMBER ~ . . #/ ~ COMPANY 1l~:rHM. SUlLEA?",J
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<br />SIGNATURE ,~UP - . STATE CERT OR REGIST * ere O\ll? :l./
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<br />OTHER 1<.0 orIN&-:::- ') / "e-
<br />SIGNATURE /s:;;:u ~
<br />~- -
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<br />COMPANY C, S-re;<}...IN6-
<br />STATE CERT' OR REGIST # CC co 5199 /"
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