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<br />MAR/31/2005/THU 11:40 AM <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />FAX No. 813-780-0021 <br /> <br />P. 002 <br /> <br />CITY OF ZEPBYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aU St, ZQphyrhi11B, 1!"L 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE Rli:CEIVED <br /> <br />OWNER'S NAME <br /> <br />lJS t\.~ U1.rJ..~ <br />fJ5'1J ~ -4-v/'C/ <br /> <br />Le..^^oU <br />'or <br /> <br />PHONE <br /> <br />9;3 - 7&1 - 5;1.77 <br />ey..j./t,3$ <br />?ll3 -~ 7 (,1- 52 Y> <br /> <br />PHONE CONTACT FOR Ps~rTTING <br /> <br />JOB ADDRESS <br /> <br />WORK PROPSEO: <br /> <br /> <br /> <br />SUBDIVISION C te sf vft i,J II>' II $ <br /> <br />LEGAL DESCRI~TIO~: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID * <br /> <br />bO <br /> <br />M RT <br /> <br /> <br />PROPOSED <br /> <br />o SIGN <br />USE ~GL. FAMILY <br />o COMMERCIAL <br /> <br />D MOVE <br /> <br />o ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DADDITION <br /> <br />DWELLING <br /> <br />DMULTI - FAMIL 11' <br />D INQ.USTRIAL <br /> <br />D f OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />DOTHER <br /> <br />DESCRI~IoN OF WORK <br /> <br />c=J RESTAURANT & <br />ew sf{(. <br /> <br /> <br />a?C ..s <br /> <br />BUILDING SIZE <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 />M BUILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ /09? 2/0 <br />. ~ <br /> <br />/..S~ AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />~f <br /> <br />Progress Ene>;gy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />I \?~q <br />~_V\ <br /> <br />" <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />D OTHER <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLOO~ ELEVATIONS <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~O <br /> <br /> <br />BUILDER . <br />SrGNA;O~ <br /> <br />STATE CERT OR REGIST t Ci3CIZS/tf4l- <br /> <br />ELECTRIcIAN <br /> <br />.**********..****.**.*.*.************~ <br /> <br />~-~~ <br />COMPANY ~ J <br /> <br />P4~lo ~e..J.r,(: <br />eRoO 1 ~SOl' <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST . <br /> <br />***-*********<<***.************-***+*********** <br /> <br />srGNATURE <br /> <br />COMPANY tJ... V)~ Lov'}" pIJM\lA~ <br />STATE CERT OR REGIST ~ ere t~ d- (,;}--"1 <br /> <br />PLOHBER <br /> <br />SIGNATURE <br /> <br />................................ * * *.................. ..~""",... "'... ...1-1>***.... *"'(. '" *.* <br />COMPANY. f'''1 S 012 A <-- . <br />STATE CERT OR REGIST ., CA<--os-o Ltc 0 <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />_~""""':":~:~:"~:;;~i;;;;"""'" <br />~_ _ STATE CERT OR REGIST It CC -CoS79CJ I <br />,.4' i <br /> <br />OTHER <br /> <br />~~"1 <br />