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<br />N ~iltJl~uV
<br />
<br />OWNER'S NAME fA S" PO m G"
<br />JOB ADDRESS . UNn ...5
<br />
<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION
<br />BUI'LDING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542
<br />813-780-0020 FAX: 813-780-0021 y 1<-\-00
<br />DATE RECEIVED -
<br />
<br />PHONE CONTACT FOR PERMITTING (8/3) 690 - /8 Bj
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<br />U 1t,t:JO fl4-r/ 0 r/ - Ie A/AI AI2..
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<br />h-6I!Mf /I1fa~ 61~
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<br />PHONE
<br />
<br />81~ - ?t:.9 - 5".:?~'7
<br />A P\ n:u"-i VI (7d.
<br />
<br />LEGAL DESCRIPTION: LOT(S)
<br />
<br />BLOCK
<br />
<br />SUBDIVISION G"_rltVP ~/a:. ~wlvtlOI71?;S
<br />
<br />PARCEL 10 # 63-J (p-:J 1-5SSS -()6()o(j-OI~O
<br />
<br />(OBTAIN FROM PROPERTY.TAX NOTICE)
<br />
<br />WORK PROPSED: )d'NEW CONSTRUCTION
<br />o SIGN
<br />PROPOSED USE: OSGL FAMILY DWELLING
<br />o COMMERCIAL
<br />
<br />o ADDITION
<br />
<br />o ALTERATION
<br />
<br />o REPAIR
<br />
<br />o INSTALL
<br />
<br />o MOVE
<br />'l'5li 1'0 w.-Jll p,-n. ES
<br />Jo'-"M{JL'fI FMHLY
<br />
<br />o DEMOLISH
<br />
<br />o INDUSTRIAL
<br />
<br />0# OF UNITS
<br />o SWIMMING POOL
<br />
<br />o MOBILE HOM
<br />o OTHER
<br />
<br />c:J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL
<br />DESCRIPTION OF WORK "0 W,VftomF!
<br />-f7~LV1 .-
<br />BUIrrDrtfGnS~ 13~, q'y b3,3r
<br />
<br />SQUARE FOOTAGE
<br />
<br />/5/ i?'I0
<br />
<br />.
<br />
<br />HEIGHT 211
<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 />PERMITS REQUESTED
<br />
<br />~ BUILDING
<br />
<br />$ 3(0 l g-9/ CO
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />o ELECTRICAL
<br />o PLUMBING
<br />
<br />AMP SERVICE
<br />
<br />~ Progress Energy 0
<br />
<br />W.R.E.C.
<br />
<br />o GAS
<br />
<br />o ROOFING
<br />
<br />:3 3 C>O()
<br />$ /
<br />o SPECIALTY
<br />
<br />/o7~ IJt4"... It) l//l/17S"
<br />VALUATION OF'MECHANCIAL INSTALLATION
<br />
<br />o OTHER
<br />
<br />o MECHANICAL
<br />
<br />TYPE OF CONSTRUCTION: QI 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 />
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<br />
<br />SIGNATURE
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<br />4iU
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<br />COMPANY tiS' /lomc CcI"r-LENIVI1/L
<br />STATE CERT OR REGI ST # CB C I ;; 5 ~ <! :2 0
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<br />BUILDER
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<br />******************************************************************
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<br />COMPANY .::Tt3C Ct..lFC''''~/ (,. Or M/Ylr~ ..... c
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<br />STATE CERT OR REGIST # EC /300 I B 8 b
<br />
<br />
<br />SIGNATURE
<br />
<br />MECHANICAL
<br />
<br />~*****~~:* .***************************************************
<br />
<br />~ -
<br />PLUMBER I' /:../ COMPANY lli<fHv/t. S'dlLE/17~~
<br />SIGNATURE //:: / STATE CERT OR REGIST # ere Ol./I?;< /
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<br />******************************************************************
<br />COMPANY A S7"E~/II//f? SrOAl<:
<br />STATE CERT OR REGIST # C I'l coSo '-I/O
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<br />SIGNATURE
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<br />*****************************************************************
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<br />OTHER
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<br />SIGNATURE ./:,0/" .. ...7-
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<br />COMPANY C. S-r!?;{LIAJ6- ,I ..
<br />STATE CERT' OR REGIST # C C C- 0 5199 /
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