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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 />BUXLDING DEPARTMENT 5335 8,"B St, ZQPhyrhi11.s, l!"L 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE Rli:CEIVED <br /> <br />OWNER'S NAME . lJS tlolW\t.. Ct,\rCf'\~ll.-- - Ll-f\^otl <br />JOB ADDRESS "7.1)50 /?::J7:" LA-#/'l!'/ >>;---'. <br /> <br />PHONE <br /> <br />gH -7lPCj -5;1..77 <br />ey..-I. /il3$ <br />'D'3'~7&1-5;L71 <br /> <br />I?HONE CONTACT FOR I?EPMI'l"TING <br /> <br />BLOCK <br /> <br /> <br />N <br /> <br />SUBDIVISION <br /> <br />IIi 115 <br /> <br />pARCEL ID it <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />WORK PROPSEO: <br /> <br />PROPOSED <br /> <br /> <br /> <br />-C./C?C?D- <br /> <br />EW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERAT ION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br />USE~GL FAMILY DWELLING <br />o COMt1ERCIAL <br /> <br />DMOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-FAMILY <br />D INL\USTRIAL <br /> <br />Of OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE nOME <br />DOTHER <br /> <br />c=J RESTAURANT & HEALTH OEPARTMENT APPROVAL <br /> <br />New sf{( j/1/lQoIe/: c/}Ar~ Z"C?t7.s <br />SQUARE FoOTAGE ~5i~ HEIGHT <br /> <br />BUILDING SIZE <br /> <br />DESCRIPTION OF WORK <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 srGN PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED_ <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />M BUILDING <br />o ELECTRICAL <br />o PLuMBING <br />o MECHANICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ ,/O//~/O <br /> <br />~ ~O AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />~f <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />Progress Enel;gy <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />D OTHER <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION:XBLOCK <br />FINISHED FLOO~ ELEVATIONS <br /> <br /> <br />ELECTRICIAN <br /> <br />SIGNATuRE <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />HECHANXCAL <br /> <br />SIGNATURE <br /> <br />o FRAME <br /> <br />D STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~O <br /> <br />********~*.****.<<*******.**..****.**.*.*-- <br /> <br />COMP)\NL_P~~ ~45W ~~(; <br />e RoO 1 LfSOl' <br /> <br />STATE CERT OR REGIST . <br /> <br />COMPANY \)" "'~ Lov~ pl"I'I~1.t <br /> <br />STATE CERT OR R~GIST # CF"C l~ ~ (d-"1 <br /> <br />. * '" *** ** * * * *** '" '" '" * o,. '" *~*,,,, '" '" * .~***- *""'(."'" *.. <br />COMPANY. f' "1 OS ()~ A <... . <br />STATE CERT OR REGIST . c.A<-05"O Ltc (:) <br /> <br />~ ~\i::~"'" '# ...... ..... .::~:::.. C: 5~i;; ~......... <br /> <br />SIGNATURE (../ STATE CERT OR REGIST * C C - Co S '799 I <br />