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<br />CITY OF ZEPHYRHILLS !:'.I!i}(M.L '.L' firr.LI.L'-'.n.... .....,... <br />BUILDING DEPARTMENT 5335 8TH st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME 5 A /'-11':> I2..J\ <br /> <br />L KimIS/iU~ <br /> <br />PHONE !if::; 77 CJ oJ c;. 0 <br />rL 335c/2- <br />SUBDIVISION Z-C P 1-1\../'1<- .t--k'''3hi:S <br /> <br />JOB ADDRESS :30.3ai 5-th (-'\Venue L(.ph~/R h ,//s / <br />LEGAL DESCRIPTION: LOT(S) ooA I BLOCK~ <br />PARCEL 10 # \ d.-'?~ d- \ 00 Y D 00 / D [) co A \ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br />PROPOSED USE: ~SGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />oMULTI - FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOMl <br />o OTHER <br /> <br />c=J RESTAURANT <br /> <br />r< .~ r C' (.' r ,) '"rl) <br />_r'! Ft <br /> <br />& HEALTH DEPARTMENT AP~ROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />,OYC <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <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 />PERMITS REQUESTED <br /> <br />o BUILDING <br /> <br />$ <br /> <br />3- 7(; C QC <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL $ <br />o GAS E5 ROOFING 0 SPECIALTY <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 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 <br /> <br />o NO <br /> <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <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 /> <br />t.."':.........".'?~~~:r. ,,. "8'} <Ii .,$,.-r COMPANY Yor r (? 0< F,"",_", <br />: ..;,~;. , ~J!~E .. ., _ _ . iQ ':..!.k: STATE CERT OR REGIST # C C c<o.J/ctSf6 <br />\ "~.:~,~,'t:?:~G1 i~~::~E:::' r <br /> <br />~ ..,.. .......1l.'"....C'.."~,,4......................."'...... <br />