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<br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECE IVED <br /> <br />i/21/o5 <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME /)OfJa../d lJi/ckrbraA-d <br />J7/JJ' CL<.j/{ IN TI~i / <br />LEGAL DESCRIPTION: LOT (S) 77 <br /> <br />~ pFRMIT SERVICE <br />1-866-824-7894 <br />o re <br />SUBDIVISIONS,kp Jill'S ell/] ai <br />. S'I/ur u~ <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />JOB ADDRESS <br /> <br />BLOCK <br /> <br />PARCEL ID # <br />WORK PROPSED:~NEW CONSTRUCTION <br />o SIGN <br /> <br />o ADDITION <br /> <br />o ALTERAT ION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />BUILDING SIZE <br /> <br />J" 'I 62-" <br /> <br />0# OF UNITS <br />~SWIMMING POOL <br />c=J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />1f1t;I'[)f.t.-A..c1 /Jet/ I-- J-.~C {OS!L-L( <br />. , ~ O'JL If <br />SQUARE FOOTAGE 7 fP /. fP <br /> <br />OMULTI-FAMILY <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />o INDUSTRIAL <br /> <br />DESCRIPTION OF WORK <br /> <br />HEIGHT <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) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />& (1) SET ENERGY <br />FORMS. <br /> <br />ICiO. 0~ <br />~..;- ~~ <br /> <br />- .;;:;-::> <br />'~)- <br /> <br />FORMS. <br /> <br />,;uJG,. <br />})Lh-C. <br />(ll'\JJllqP; . <br /> <br />fjJ BUILDING <br />~ ELECTRICAL <br />~ PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />J rJ, <fiX) , oa <br /> <br />, <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <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 />BUILDER <br /> <br />COMPANY i7T1J '()J/ {'~~l/WJ/A; Dr <br /> <br />SIGNATURE <br /> <br />\..jV~L U{ , <br />(/ <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />SIGZ <br /> <br /> <br />PLUMBER <br /> <br /> <br />COMPANyMQu..:>\(Jn~ (_ ~ C Sue Co <br />STATE CERT OR REGIST # ~~ L \. 2. \ <br /> <br />********************************************************** <br /> <br />COMPANY <br /> <br />1'19 fJ cd. <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 ?coL t n.dOSL.tre.... <br />SIGNATURE f-.oUJdd. e/.l~b <br /> <br />COMPANY <br /> <br />MQ. C~tJSTRVOlDD <br /> <br />STATE CERT OR REGIST # <br />