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<br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION <br />BUI'LDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />'~L~ ~ <br /> <br />PHONE CONTACT FOR <br /> <br />DATE RECE IVEO 6,,;2'7- ~? <br />PE~ITTING (813) gC;o -18 8S" <br /> <br />JOB ADDRESS <br /> <br />U teAJfl4 r/ Or; - Le A,/A/ AI2.. <br /> <br />AClr~ ~n R.rfJ.fJ. <br />3D. BLOCK ~ <br />-rxx:f1J'- 03Cb <br /> <br />PHONE 81 ~ - 709 - S..:??'7 <br />PJI A S ~ - On., \- \0 61<::'" <br />SUBDIVISION Git.P9tVQ /J/t'J:. --T;,uIW/ot7T?.5 <br /> <br />OWNER'S NAME fA S' //0 fJ1 G" <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 10 # 03" 2h" Zl- <br /> <br />(OBTAIN FROM PROPERTY , TAX NOTICE) <br /> <br />WORK PROPSED: ~'NEW CONSTRUCTION <br />o SIGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERC IAL <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br />'l"5d '10 w ,vtl 0,")\ e-S <br />~'W:lL'l'I PM1I1Y <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 AP~ROVAL <br />loW,V/fomES aJDOOl. g, CrO\'/ <br /> <br />SQUARE FOOTAGE ~ HEIGHT <br /> <br />21 ' <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 />NOC <br /> <br />~ BUILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />~ PERMITS REQUESTED <br />S f3 J 520 ,'B- VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />~ Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />VALUATION OF'MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />$ <br /> <br />TYPE OF CONSTRUCTION: QI 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 />BUILDER <br /> <br />flK;;{~ <br /> <br />COMPANY tiS ,l/omc atf-I"-LENIV/I/Z- <br />STATE CERT OR REGIST # CBcl;JS-::l</:J.to <br /> <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN. . _~~~ <br />SIGNATURE ~ <br /> <br />PLUMBER ~.~..................:::::::..;;;;~:~.~~:::~.~... <br />SIGNATURE. #~ 47(- STATE CERT OR REGIST # ere Olll? :z../ <br />{/ <br /> <br />COMPANY .:::Ti3C Cc...€c-1'~1 c.. 01= MM~~ <br />STATE CERT OR REGIST # EC /300 I B 8 b <br /> <br />SIGNATURE <br /> <br /> <br />**************************************************** <br />COMPANY A .s""'E~//lI/~ SrOA/F <br /> <br />STATE CERT OR REGrST # C I'l CoSO '-//0 <br /> <br />MECHANICAL <br /> <br />***************************************************************** <br /> <br />OTHER 1<0 O("JN~ <br />SIGNATURE ~ V <br />V <br /> <br />COMPANY C. S-re/(I-IA./6- <br />STATE CERT' OR REGIST # C C c.. 0 5?9 9 / <br />