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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8ft St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br />PASC8 F\..~Mlr :5co/ltv I<=E <br />PHONE CONTACT FOR PERMITTING -+ ~,,6, 13'" t '1~"'" <br /> <br />JOB ADDRESS <br /> <br />J/719 <br /> <br />JJ tLro/ c/ J/ 4... 1/ <br />E ;e &11 <br />.51 <br />OM - ~~ -J/- ()02~- a::tUJ- ()Jlu <br /> <br />PHONE <br /> <br />7/S- Dirt? <br /> <br />OWNER'S NAME <br /> <br />L tL,A...L <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION OuJ( CrNf &. fJA-/ <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: yQNEW CONSTRUCTION <br />DSIGN <br /> <br />o ADDITION <br />o MOVE <br /> <br />DALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE:~SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />DESCRIPTION OF WORK \S~I/ rO()ln a.A.-I ~b .LX./;.J-IA.5 <br />BUILDING SIZE fJ. 't fO I SQUARE FOOTAGE Irl()1 <br /> <br /><fk/; <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 />~ BUILDING <br />o ELECTRICAL <br /> <br />L{-/ i) '6 D. .r <br />~, GOO. (}J <br />. <br /> <br />PERMITS REQUESTED <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />D ROOFING <br /> <br />D SPECIALTY <br /> <br />D OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />D STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br />BUIlDER ~ <br />SIGNATURE ,~ <br /> <br />COMPANY <br /> <br />OVAar <br /> <br />I <br /> <br />4<()ZJ~ <br /> <br />.' ..... - '", -,--,." .... .~.._.... ."-.-. .-_. .'. ....' _.... .....-. .. ,'.'- - ". ... -'-' '-, <br />C' 'e' 'N' ~"'''''~' 'S"m'R' ",S' 'z' C'D;:[a~ <br />..'_ !.~. . ,'c.... ;.. . . r-,'_ ',.:-.. .,. <br />~" _' ,_.,. .- ';, t.. ..:: _.,,' ,.~,_'_ :!~~..:_,:-.- ._",',.,.,-:~. ,- ," _ - "f,'" ,.,< _ _; , <br /> <br />STATE CERT OR REGIST # <br /> <br />~.\.v. <br />~ <br />~\) ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />COMPANY <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 REG 1ST # <br />