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<br />II I <br /> <br />CI~Y OF ZEPHYRHILLS PERMIT APPLICATION <br />BUI'LDING DEPARTMENT 5335 a'H St, Zephyrhills, FL 33542 <br />813-780-0020 FAX:a13-7aO-0021 <br /> <br />;5P$ .p '? <br /> <br />DATE RECEIVED <br /> <br />&> - :2/-0? <br /> <br />PHONE CONTACT FOR PERMITTING (8/3) g90 -18 8S' <br /> <br />OWNER'S NAME fA S /10 IJJ G' <br /> <br /> <br />PHONE 81 ~ - ?" 9 - S-.;;r; '7 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />E'ARCEJL I D # 0'3" 2.ft" 2.1- <br />WORK PROPSED: Jd'NEW CONSTRUCTION <br />OSIGN <br /> <br />BLOCK ~ <br /> <br />-[j1)(j). 22 bO <br /> <br />SUBDIVISION GiU'9'/o ~/l'j:" t;.u/w-/ol11r;.s <br /> <br />(OBTAIN FROM PROPERTY , TAX NOTICE) <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />'l"ili '10w,oJ1'Io,......e-S <br />,.....WJL'fi PMHLY- <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 />DESCRIPTION OF WORK <br /> <br />c=J RESTAURANT & HEALTH <br />'10 WiVf!om€S <br /> <br />a1~ <br /> <br />FOOTAGE ~ \063 <br /> <br />DEPARTMENT APpROVAL <br /> <br />(Y1C1.lfjn I'~f).e, <br />HEIGHT 2/ ' <br /> <br />BUILDING SIZE <br /> <br />SQUARE <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 />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />~ PERMITS REQUESTED <br />$~ 11 go. <:Q..- VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />~ Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />$ '3 300- - <br />\ <br /> <br />o SPECIALTY <br /> <br />VALUATION OF'MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: DJ 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 />SIGNATURE <br /> <br />~ <br /> <br />COMPANY tlS'lIom'E Cb''''r-LEIVIV/1/l- <br />STATE CERT OR REGIST # CB C I::? 5::2 <!::2 0 <br /> <br />BUILDER <br /> <br />//" ~****************************************************************** <br /> <br /> <br />ELEC$I~I"" ? d COMPANY .:78 C to UF U '" I (. a f' "1rl/HI"'i <br />SIGNATURE . (;f'<:?""'{),:::' . STATE CERT OR REGIST # EC /300 I B 8 b <br />****************************************************************** <br />PLUMBER. ~ /1/ COMPANY ll~rHrJ/t. S'cIILEP7I'/~ <br />SIGNATUR/? ? 4<< /" - . . STATE CERT OR REGIST # ere 0 \It ? ;z / <br />********* ****************************************************** <br />MECHANICAL COMPANY A SrE~;:'II/Iv- SrOA/& <br />SIGNA~Uf<.E I STATE CERT OR REGIST # C I"l COSo t.//O <br /> <br /> <br />***************************************************************** <br /> <br />OTHER ({o m--~ <br />SIGNATURE c / <br />./ <br /> <br />COMPANY C. S r-f?;{t.. / AI?- <br />STATE CERT' 'ORREGIST # CcCO 5199/ <br />