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<br />CITY OF Zt;J:'t1~~n.L.u.u..... ... ------ <br />BUILDING DEPARTMENT 5335 8TH st, ZephyrhillS, FL 33542 <br />813-780-0020 FAX:B13-780-0021 <br /> <br />DATE RECEIVED <br /> <br />J{ (21'(0 ~ <br /> <br />JOB ADDRESS <br /> <br />~.~ Cf!~~:r, elMI >'" <br />6 ifl.f.} ,~ . ~ ,lZ Fe-! <br /> <br />PHONE GONTACT FOR PERMITTING 1r2/)..qtj33 <br />(f13) 'i{,q- 5lfll u.fi# <br />PHONE ~-" <br />( \ <br />(2-H OlD J per:;;,- L/ L ~"Jj, J J ) <br /> <br />.... <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT (S) II BLOCK b3 <br />PARCEL 10 # J I ~~ <:( J DO I 0 (j ~b(J 0 () J I 0 <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE\ <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />Djt OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HO~ <br /> <br />.JL OTHER <br />s: 7pA-Fl' 6> f' <br />;3 'L-P(;, <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT AP~ROVAL <br /> <br />DESCRIPTION OF WORK <br /> <br />111) 5>1.f"1 L L <br /> <br />A i.,fCt:'~D'1 <br />SQUARE <br /> <br />c () 1'0 ~ ,... /'. u c -rt; i) s ro /wr;:'; 15 to (... [;;, ) ,I{. 'l <br />J <br />FOOTAGE AfP:rc....', I J-} 0 HEIGHT <br /> <br />BUILDING SIZE <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{RMS. <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. (p /4 ~ (j..J1G <br /> <br />/0 X jt.} <br /> <br />PERMITS REQUESTED <br /> <br />kBUILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />c>2 d t.} S; .y,~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o Progress Energy <br /> <br /> <br />$ <br /> <br />VALUATION OF <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <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 0 NO <br /> <br /> <br />SIGNATUREJ. <br /> <br />. vH' ~ ~ ~.J,~,.J, <br />~. ~ ~ ~ ~ STATE CERT OR REGIST * <br />****************************************************************** <br /> <br />COMPANY <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />PLUMBER <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />****************************************************************** <br /> <br />COMPANY <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />***************************************************************** <br /> <br />OTHER~ <br />SIGNATURE <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST # <br />