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<br />NOV/15/2004/MON 09:02 AM ZEPHYRHILLS BUILDING <br /> <br />FAX No, 813-780-0021 <br /> <br />p, 001 <br /> <br />CITY OF ZEPBYRRXLLS PERMIT APPLICATXON <br />13TJILOING DEPARTMENT 5335 S'H St, l1:ephydul1s, FL 33542 <br />B13-7aO~0020 FAX: 813-780-0021 <br /> <br />DATi: RECEIVEb <br /> <br />iJ-/S-O{ <br /> <br />PHONE CONTACT i'OR PlilRMITTING <br /> <br />OWNER; S Nl\ME.f) e. ,-/)/ j f!, & If ej -;; A~; <br />JOB ADDRESS d.jl6~i1 ~d; /Ire.. <br /> <br />PHONE f /.3 7 Jl3yi7t1 9 <br />...2czjJllj ;<1I;L-L--5 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID jI <br /> <br />(ORTATN FROM PROPERTY TAX NOTICE}, <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br />DSIGN <br />PROPOSED USE,ItSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />D ADDITION <br /> <br />DALTERATION <br />o DEMOLISH <br /> <br />d REE:AIR <br /> <br />D INSTALL <br /> <br />o }lOVE <br /> <br />DMOLTI-FAMILY <br />D INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />DOTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />D RESTAURANT <br /> <br />If ep1-A(!.~ <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />/?IXJF.5IIlj) Q le s <br />.,.0 <br />SQUARE FOOTAGE <br /> <br />HEIGliT <br /> <br />BUILDING SIZE <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) BETS OF ENGINEERED PLANS REQUIRtD. <br />, PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />/~\ <br /> <br />/",,,-_/ . ; <br /> <br />// j!ie&) <br />W'R.E~ <br /> <br />f'l5~O <br /> <br />PERMITS REQUESTED <br /> <br />~ BUIL~ING <br />[j eLECTRICAL <br />d PLUMBING <br />o MECHANICAL $ <br />o GAS ~OOFING D SPEClJU.TY <br />TYPJ;: OF CONSTRUCTION: D BLOCK <br /> <br />$ <br /> <br />VALUATrDN OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D Progress Energy <br /> <br />D <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />D OTHER <br /> <br />D FRAME <br /> <br />D STEEL <br /> <br />D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE /\.READ YES J( NO <br /> <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST * <br /> <br />* * * * *****'** * * * *' ***'* * '* *' * '* * *' **** '*"* '* '* '* * * ** * * * * * **.. * * * * * ***.. * *' ** *** 'II: '* * <br /> <br />ELECTRICiAN <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST * <br /> <br />****************~*~~****~*********~*************************~***** <br /> <br />PLuMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST * <br /> <br />***.****************.**********.~*******************************~** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST * <br /> <br />***************************************************************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST * <br />