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<br />-~Vn~ <br /> <br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION <br />BUIiLDING DEPARTMENT 5335 BTH St, Zephyrhills, FL 33542 <br />813-7BO-0020 FAX:B13-7BO-0021 <br /> <br />PHONE CONTACT FOR <br /> <br />DATE RECEIVED ~ ~ -tJ~ <br />PERMITTING (8/3) gC;o -18 8S" <br /> <br />JOB ADDRE S S <br /> <br />Co IipotZ4f/ 0"/ - Ie 1/ N' 't;; PHONE 812> - ? 6 9 - S';;'1 ') <br />'flam ( ~f\- od - 8!d.'S~ - On,I-' <br />J.7 BLOCK (/) SUBDIVISION GIt..ntVo ~It'j:. -r;<utV'/Of11~;S <br />~ D2..ID (OBTAIN FROM PROPERTY. TAX NOTICE) <br /> <br />OWNER'S NAME fA S /10 IJ1 G" <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 10 # D3.. Z~ "V- <br /> <br />WORK PROPSED: )d'NEW CONSTRUCTION <br />DSIGN <br />PROPOSED USE: DSGL 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 /> <br />'l";d' '10 w.v;l <>."1\ E-S <br />P~L'fI PMlILY <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 />BUILDING SIZE <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />'/0 w,v/iom€S (Yk>d~ (Y1a( fr.t) I~ u..e <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. <br /> <br />NDt.- <br /> <br />-- <br /> <br />~ BUILDING <br /> <br />PERMITS REQUESTED <br />$~ , 1 g() \ ~ VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />o PLUMBING <br /> <br />AMP SERVICE <br /> <br />~ Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o MECHANICAL <br /> <br />$ 3'\~roL./ <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: OJ 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 /> <br /> <br />---- <br /> <br />COMPANY tI S lIom~ Cf,rt.r- LEN/V/l1L <br />STATE CERT OR REGI ST # CB C I ;; 5:::2 f../ :J. 0 <br /> <br />BUILDER <br /> <br />SIGNATURE , <br /> <br />/ <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br /> <br />COMPANY .::T13 C Ct-~C"f~1 ~ 0;: 'Ir1mr/J <br />STATE CERT OR REGIST # EC /300/9 B b <br /> <br />ELECTRICIAN <br /> <br />************************************************** <br /> <br /> <br />PLUMBER ~""f COMPANY #,(.1'1/",,_ SUlLE""..) <br /> <br />SIGNATURE /;:ii?{~-1f!II' ---== STATE CERT OR REGIST it ere 0 l./ / ? ~ / <br /> <br />// **** ** ~****** * J*** * * **** **** * ***** ** ** ****** ******* ***** * *** <br />MECHANICAL ;:'~." COMPANY A SrE~;::'ltV~ SrOA./? <br /> <br />SIGNATURE ~~~/ STATE CERT OR REGIST # C 1'1 COSO 1.//0 <br /> <br />/ <br />OTHER ((0 or~ ' <br />SIGNATURE ~. '// <br /> <br /> <br />***************************************************************** <br /> <br />COMPANV C. S-ret<).../N6- <br />STATE CERT'OR REGIST i CC C 0 5199 / <br /> <br />-- <br />