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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 B"s St, Zo;ophyrhi11.s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE Rli:CE IVED <br /> <br />OWNER'S NAME~1V\t. G,\fC(?l~llr--. - Le...A^qf , <br />JOB ADDRESS . 1110'"6 ~/; L6l-U/'~/ Dr. <br /> <br />PHONE <br /> <br />gl3 -](/J -5:2.77 <br />e",,-I./I43$ <br />'D/3~~7~1-5~-n <br /> <br />FHONE CONTACT FOR FEPMITTING <br /> <br />PARCEL ID It <br /> <br /> <br />-;.. z~-- Z/-s s -~- // 0 <br /> <br /> <br />Cte5Jv~i,J t-lill$ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />WORK PROPSEO: <br /> <br />EW CONSTRUCTION <br /> <br />o ADDITION o ALTERAT ION o REPAIR o INSTALL <br />o MOVE 0 DEMOLISH <br />DMOLTI-FAMILY Of OF ONITS o HOBILE HOME <br />o INI:\USTRIAL o SWIMMING POOL o OTHER <br /> <br />PROPOSED <br /> <br />OSIGN <br />USE~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DESCRIPTJ:ON OF WORK <br /> <br />r::::=J <br />New <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />'L1/l~oIe/: Brlc/C?~r~ ZOO~- <br />SQUARE FOOTAGE Z# 6, <br /> <br />sf{( , <br />) <br /> <br />BUILDING SIZE <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 />M BUILDING <br />o ELECTRICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ / Zb ,6cY-b. <br />ZOO <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />~f Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o 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 />SIGNA;otE <br /> <br />STATE CERT OR REGIST t C/3C/ZS/r/4.l., <br /> <br />**-******** <br /> <br />**~**.****.*******.***.*******.***** <br /> <br />COMPANY D~..J- P<t5l.o ~e..J.pC <br />e RoO t LfSOl' <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST t <br /> <br />******************.***.~**w*******.******~********* <br /> <br />FJ:.1JHBER <br /> <br />COMPANY l)" \I)-.{ LOIlj<c PIVM\!"~ <br />STATE CERT OR REGIST ~ C F"C lot: d (.;)-'1 <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />...... ........ * ............... ......... ... ... ... ...... ... ... '" ~... ,* ...... ..~...~............ * "'(."''''.''' <br />COMPANY. to "1 ':::> Of. A <-- - <br />STATE CERT OR REGIST .. c.A-C- 05"0 Ltc 0 <br /> <br />Ml!:CHANICA:L. <br /> <br />OTHER <br /> <br />~~"1 <br /> <br />~""""""""::~:~:"~:;:~i7;;;"""." <br /> <br />v- .. STATE CERT OR REGIST * CC -CoS7 9 Cj I <br /> <br />SIGNATURE <br />