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<br />1}#1 ~r <br /> <br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION <br />BUI'LDING DEPARTMENT 5335 8TH at, Zephyrhills, FL 33542 <br />\ 813-780-0020 FAX: 813-780-0021 ~ - -') 9-C<O <br />.J DATE RECEIVED - ,~ - - <br /> <br />I PHONE CONTACT FOR PERMITTING ($/3) e90 -18 8.J' <br /> <br />U It//O tl/f r/ 0 r/ - Le AijI AIZ... <br /> <br />Ao. (aJW'- RiwJ.. <br />~3b. BLOCK 0' <br />- CY:J::lj:) . 2.310 D <br /> <br />PHONE 81 ~ - ?~ 9 - 5".;?"J '7 <br /> <br />OWNER'S NAME fA S /10 mE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 10 # 03 '2b.. 2J . <br /> <br />SUBDIVISION Gif..PltVP ~/l'j:. --r;"",vtlOf1f~.s <br /> <br />(OBTAIN FROM PROPERTY.TAX NOTICE) <br /> <br />WORK PROPSED: Jd'NEW CONSTRUCTION <br />o SIGN <br />PROPOSED USE: [JSGL FAMILY DWELLING <br />[J COMMERCIAL <br /> <br />[J ADDITION <br /> <br />[JALTERATION <br /> <br />[] REPAIR <br /> <br />[] INSTALL <br /> <br />o MOVE <br />'1"Ri 'low.vil o.-nE-S <br />,.......wuLTI PMlIL'f <br /> <br />o DEMOLISH <br /> <br />o INDUSTRIAL <br /> <br />[]# OF UNITS <br />[J SWIMMING POOL <br /> <br />[] MOBILE HOM <br />[] OTHER <br /> <br />BUILDING SIZE <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APpROVAL <br />"0 w,v/tomFS Ma;I--eA , (Y1ar-/1 fI ,.~(;-c.., <br /> <br />SQUARE FOOTAGE \~t,23 HEIGHT <br /> <br />DESCRIPTION OF WORK <br /> <br />oU'" <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~ BUILDING <br /> <br />PERMITS REQUESTED <br />$~ J 1 go J!!- VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br />[] PLUMBING <br />o MECHANICAL <br /> <br />AMP SERVICE <br /> <br />~ Progress Energy [] <br /> <br />W.R.E.C. <br /> <br />$ , t 3&0"- <br /> <br />VALUATION OF'MECHANCIAL INSTALLATION <br />[] OTHER <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: DJ BLOCK <br /> <br />[] FRAME <br /> <br />[] STEEL <br /> <br />[] OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES [] NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY tiS' lIoml: C~j"r-LEN/VI1/Z- <br />STATE CERT OR REGIST # CB C I ::l5;2 C/::2 0 <br /> <br />****************************************************************** <br /> <br />,;, <br /> <br /> <br />COMPANY .::Ti3C Ct.-tE-'C,"(tCl c.. Or: 'Mmpl9 <br />. " <br /> <br />STATE CERT OR REGIST # EC /300 I 9 8 b <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />*************** <br /> <br />************************************************** <br /> <br />SIGNATURE <br /> <br /> <br />."' <br /> <br />COMPANY 1l~'f'lltJ/!.. SC.tl L€' /171'/ ~ <br />STATE CERT OR REGIST # ere 0 ill? ~ / <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />********~***************************************************** <br />~//~; ? /' COMPANY A SrEI"I"IN'v SrO,v!i <br /> <br />/~ j ~___ STATE CERT OR REGIST # C r; COSO '-I/O <br />/ - <br />***************************************************************** <br /> <br />",/ <br />MECHANICAL <br /> <br />OTHER <br /> <br />f(OO~ ~ <br />SIGNATURE F /- <br /> <br />COMPANY C. S-re-~/....IAJ6- <br />STATE CEE~T' ORREGIST#- C Ce...O 519 CJ / <br />