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<br />MJ.R/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 />BU:ILDING DEPARTMENT 5335 8- St, ZQphyrhi11s. FL 33542 <br />813-7BO-0020 FAX:B13-780-0021 <br /> <br />DATE RECEIVED__ <br /> <br />OWNER'S NAME lJS tio~ Cc\fl}r^~ll.-- - <br />JOB ADDRESS 71-?JD ~~(.h~-/t//d <br /> <br />C,l ;).JJ <br /> <br />Ll-^^~.r <br />er. <br /> <br />9;3 -7~<J -oJ'''" <br />e'f-J./il3$ <br />?JI3 ~7(/l- S;t Y> <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />PHONE <br /> <br /> <br />BLOCK <br /> <br />C fe 5/ vft w I-/NI $ <br /> <br />PARCEL ID * <br /> <br />LEGAL DESCRIPTIO~: LOT(S) <br /> <br />H <br /> <br />RT <br /> <br /> <br />WORK PROPSED: <br /> <br />PROPOSED <br /> <br />SUBDIVISION <br /> <br /> <br />.;. ? <br /> <br />o ADDITION <br /> <br />o MOVE <br /> <br />o ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br />USE~GL. FAMILY <br />o COMMERC IAL <br /> <br />DMULTI-FAMILY <br />o IND,USTRIAL <br /> <br />D. OF UNITS <br />o SWIMMING POOL <br /> <br />D MOBILE HOME <br />DOTHER <br /> <br />DWELLING <br /> <br />C::J <br />/Jew <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />.A/lQc/e/: O-krbrd ~003 <br />SQUARE FOOTAGE /9z/;) <br /> <br />sf {( . <br />) <br /> <br />BUILDING SIZE <br /> <br />DESCRIP'.r:ION OF WORK <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 />~ BUILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ /O~ P"/O <br />/~~O <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />~. Progress Energy 0 <br /> <br />AMP SERVICE <br /> <br />W.R_E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAs 0 ROOFING 0 SPECIALTY <br />TYP~ 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 />ELECTRIC:J:AN <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />SIGNATURE: <br /> <br />MECHAN:rCAX. <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST t Cf3C /ZS/rl4-L <br /> <br />*.***************..*******************************....*.********** <br /> <br />c: - ..A- <br />COMPANY ~~ <br /> <br /> <br />P4Sl.o ~~(: <br />e Roo, 'I SOl , <br /> <br />STATE CERT OR REGIST t <br /> <br />****.******.************..*..************~*********** <br /> <br />COMPANY l)... \1)-.( Lov')" PIJM\lAe <br />STATE CERT OR REGIST ~ C-F'C tf ~ {d-'1 <br /> <br />. .***********.****..*~*:****1i******r.*** <br />COMPANY. f' "1 'S oe. A ~. . <br />STATE CERT OR REGIST .. C-A<--OS-O Ltc (:) <br /> <br />OTHER <br /> <br />~~;:~""'~""""""':~:~:"~:;;~i;;;:"""'" <br />SIGNATURE ~ STATE CER-r OR REGIST * CC -CoS799 / <br />.", <br />