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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 <br /> <br />If-'l-dtc <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME E ;: ~ <:- 2 6 e /4 /1. 0dJ k /"--1 <br />JOB ADDRESS 6t~t~ ~ r T: Ie: I ',A) t? ~ rI <br />./ <br /> <br />PHONE 7.p-.d - (p II ~ <br />:z e- v t. L/ ~ It I' / /J.'- , ~ ~ <br />/ / ~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # ~S -~ 6 - Oll ~ c!J 61 0 <!) - (9 tJJ>tJe -CJ c!J~ D (OBTAIN FROM PROPERTY 'rAX NOTICE) <br /> <br />WORK PROPSED: ONEW CONSTRUCTION o ADDITION ~ALTERATION o REPAIR o INSTALL <br /> Os I GN o MOVE 0 DEMOLISH <br />PROPOSED USE: DSGL FAMILY DWELLING DMULT I - FAMIL Y 0# OF UNITS o MOBILE HOME <br /> l&cOMMERCIAL o INDUSTRIAL o SWIMMING POOL o OTHER <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />DESCRIPTION OF WORK Lv I ~ re ,'J)~ R e lA.--( ~ ciJ // IN () f b ILl t4' 6 " NI) r ~ Ac ~c ( C.:\ / <br />i-' "--/ A" ~ ' C" x t & It "t'/~ (tt ~ {f / / f ./ <br />BUILDING SIZE SQUARE FOOTAGE HEIGHT <br /> <br />RESIDEN'rIAL: 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 PERMI'l' ONLY (2) SETS OF' ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUC'rION. "JoL <br /> <br />o BUILDING <br /> <br />$ <br /> <br />iJtJ <br />~/"tJtJ - <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o FLOR IDA POWER <br /> <br />o W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />o GAS <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 S'l'EEL <br /> <br />o OTHER <br /> <br />F'INISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br /> <br />.~_._.__._---........ .>... ......... .. .. .1 <br />COMPANY~ t- J..! L \ s: /.A.-t ,'; It' (!. tJ NC ~ k/..) c... <br /> <br />STATE CERT OR REGIST # CIS c ~s:-?'S/ jj' <br /> <br />BUlillER ~ ~/ <br />SIGNATURE 7 . L <br />vr - <br /> <br />**.*****.****** <br /> <br />SIGNATURE <br /> <br /> <br />************************************************ <br /> <br />@ <br /> <br />ELECTRICI <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br />(5'fL <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # _ <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />SIGNATURE <br /> <br /> <br />COMPANY <br /> <br /> <br />rot (~11&:.. ~~i~A j ,.I~...c:J:m:'IO ~', .t.ti ~ <br />d1;." r ~ CO . ~()!i.~.'Tlf!!<.':) \ <br />nu.A ~oM j6IXl"i.~1 t8 btbno8"..!,:.." <br />