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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED '.0/ <; (019 <br />PASCO P~RMrr S~lfICE <br />PHONE CONTACT FOR PERMITTING 1-.giOG7-g;l.z.t-789LJ <br /> <br />OWNER'S NAME <br /> <br />Jack. <br /> <br />J7033 <br /> <br />flam / /~) <br />LJ(y &~ ,4t;e <br />~S() <br />J,/ -~~-rJ./-O/7() ~ CJoGttJ-<:9lS-aJ <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION &.FtULcI 1I00"";Zo/)J ,/J-S <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID # <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~NEW 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: DSGL 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 />DESeRIPTION OF WORK <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />(LrL / t1 / q,..JJ tv Ii) rb/L).f T ~tek~ ~ <br /> <br />(/ SQUARE FOOTAGE /9&-1 <br /> <br />-e-x Id > rJ 6UJL/7 IW/fl <br /> <br />BUILDING SIZE <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1 ) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />N(':>C <br /> <br />(JJ <br />7/ eJ 9,). <br /> <br />PERMiTS REQUESTED <br /> <br />jtJ BUILDING <br />'r/J ELECTRICAL <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 />DGAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <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 />BUILDER <br /> <br />. '.",.-. ... ._.-- <br />, ~~ <br /> <br />~.! .", ...,.,.,.... <br /> <br />IDS. f)D r -!.J -4-~UJ!/JrJ D-C <br /> <br /> <br />SIGNATURE <br /> <br />~LQ~ <br /> <br />~ <br /> <br />STATE CERT OR REGIST # <br /> <br />(' (, :Z) <br /> <br />"--"',- <br /> <br />* * * * * * ** * * * * * * * * * * 0":* * * ~ * * * * * ** * * * * * * * ** * * * * * * * ** * * * * * ** * * * <br /> <br /> <br />ELECTRICIAN . ( 35.. ~o ') COMPANY fur t/4J-f E~~.j.ru ~ <br />~CLtA- ~ ~/ <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />S rGNATURE <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 # <br />