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<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION
<br />BUIiLDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542
<br />813-780-0020 FAX: 813-780-0021
<br />
<br />DATE RECEIVED
<br />
<br />b-;l9-P~
<br />
<br />PHONE CONTACT FOR PERMITTING (813) eC;O -18 8S'
<br />
<br />JOB ADDRESS
<br />
<br />6"'PJfl4f,O,.l- kr:a1L PHONE 81Zl- 769 - 5'.:??')
<br />Jam 11Jf\. _ _ _cl- 6161:13 - 0",,- "'J
<br />23 BLOCK 9> SUBDIVISION GiLH;VO ~tt'k. "";~vlvHot11~.s
<br />,t:fJ.:1X)-- 6280 (OBTAIN FROM PROPERTY. TAX NOTICE)
<br />
<br />OWNER'S NAME fA S lIomG
<br />
<br />LEGAL DESCRIPTION: LOT(S)
<br />PARCEL I D # Q:'l" 2". '2.1..
<br />
<br />WORK PROPSED: JONEW CONSTRUCTION
<br />o SIGN
<br />
<br />o ADDITION
<br />o MOVE
<br />
<br />o ALTERATION
<br />o DEMOLISH
<br />
<br />o REPAIR
<br />
<br />o INSTALL
<br />
<br />'l"iZi 'Tow.oJ+! O,"l\ E..s
<br />PROPOSED USE: DSGL FAMILY DWELLING P-WULfi PMHLY
<br />o COMMERCIAL 0 INDUSTRIAL
<br />
<br />0# OF UNITS
<br />o SWIMMING POOL
<br />
<br />o MOBILE HOM
<br />o OTHER
<br />
<br />BUILDING SIZE
<br />
<br />c:J RESTAURANT & HEALTH DEPARTMENT APpROVAL
<br />',oWlJ/tomES (VlodeA . SlestrL Ke~
<br />
<br />SQUARE FOOTAGE ~ HEIGHT ~
<br />
<br />DESCRIPTION OF WORK
<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. ~L-
<br />
<br />~ BUILDING
<br />
<br />l!lE/7ID/gL
<br />
<br />PERMITS REQUESTED
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />o ELECTRICAL
<br />o PLUMBING
<br />o MECHANICAL
<br />
<br />AMP SERVICE
<br />
<br />~ Progress Energy 0
<br />
<br />W.R.E.C.
<br />
<br />$ ~ ~OOl./
<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: QiI 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 />~1'il'.~r"""'lIT'Tlr't'T'-~~"'-'j'!I""I~""'~ l~- 'IrT"'~"- "l""rrl~"T ,. r 'rrl-~''''~l' '!-rr l-~- -r ~~- _r- ~--+ - - - + --~ -+ ']I"~I!:: 'I" II' ~ 1'1 I' ,I' 1,"1"1 -~ p1"'r' II 1';1'1!'1l1""ij'111'
<br />111111:>,'11 ':: :"'"'1":' i 'I',' ~""': 'f" "'I,, ,"'I' !I", I I,:' ;'" , :, I"" I ' ',,',' "1',""""1',':' II'! "'li,,,;I';'II!ill'lli,,!i,'loI},',1 i:III,.I~;'}';JII:i'liiW:lj;1
<br />
<br />d~~l:~mhJj~ ':~~ ~.',~j~ ~L'.cI__d~ 1':1,_,,:: ,j.lL.,'~, ~"':':""':'-l_____ _ ______ __ ___ ~_ _____ ~ _ ~ - _.L :'_~.d:~1 L~"..'..:DL~_ll~l !U'L:.,~l,,-~~_bij_:dicillJ;rul
<br />
<br />BUILDER
<br />
<br />
<br />COMPANY tiS lIom~ C~I~-LEN/V/I/Z-
<br />STATE CERT OR REGIST # CO C I ;;J 5;). f../ ::Uo
<br />
<br />******************************************************************
<br />
<br />ELECTRICIAN b ~"
<br />SIGNATURE
<br />******************************************************************
<br />
<br />COMPANY .:TI3C C(.J:=C'1"~/ G tJr Mt'I'1r/J
<br />STATE CERT OR REGIST # EC /300 I B 8 b
<br />
<br />MECHANICAL
<br />
<br />
<br />*******************************************************
<br />COMPANY A S""'EjC7/IIV~ Srol,/(F
<br />
<br />STATE CERT OR REGIST # C t1 COSO '-//0
<br />
<br />PLUMBER
<br />
<br />COMPANY llt<flliJ./{, SC.flt..EP71'/,J
<br />STATE CERT OR REGIST # ere 0 l.//?:< /
<br />
<br />*****************************************************************
<br />
<br />OTHER 1<0 or:~ /
<br />SIGNATURE J---- - ~- - -- --~
<br />
<br />COMPANY C. S-rel<I-IN6-
<br />STATE CERT' OR REGIST #C ceo 5199 /
<br />
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