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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 />BUJ:LDING DEPARTMENT 5335 8"8 St, Z",phyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE REel: IVED <br /> <br />~f'\t. Cc\rt[?\~lIr- - Lf.-A^OLt ' <br />~YCh~ /,v//k . L~~- <br /> <br />flt3 -7(/j -5;1..77 <br />e>f+./t,35 <br />?l i3 ~~ 7 (/j - 5:J.. 71 <br /> <br />PHONE CON"J."ACT FOR PE~rTTING <br /> <br />OWNER'S NAME lJ S <br />JOB ADDRESS 713 (, <br /> <br />PHONE <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />C fe 51 vrt i-J II; II S" <br /> <br />PARCEL ID it <br /> <br />LEGAL DESCRIPTIO~: I.OT(S) <br /> <br />M <br /> <br />RT <br /> <br />N <br /> <br />WORK PROPSED: <br /> <br />PROPOSED <br /> <br />3S- ZS'-- Z / - ..> S <br /> <br />z..o <br /> <br />c -- OOa.r/ <br /> <br />EW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br />USE~GL FAMILY <br />o COMMERCIAL <br /> <br />o DEMOLISlI <br /> <br />o MOVE <br /> <br />DWELLING <br /> <br />DMULTI-FAMILY <br />o INo.USTRIAL <br /> <br />o If OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />r=:J <br />N(!vJ <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />. A/lqole/: /7'r7 c/f;,l(',t?' r c:..t~S;- <br />SQUARE FOOTAGE z,<j/ / .6 <br /> <br />sfR. ' <br />) <br /> <br />BUILDING SIZE <br /> <br />OESCRI~J:ON OF WORK <br /> <br />HEIGHT <br /> <br />RESIDENTIAL:. ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING pLANS & (1) SET ENERGY FORMS. <br />COMMERCrAL: 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 E:LECTRrCAL <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />PERMITS REQUESTED <br /> <br />$/'Z6/6?6 <br />tr <br />ZOD AMP SJ;:RVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />~' <br /> <br />o <br /> <br />W.R.E.C_ <br /> <br />Progress EneJ;"gy <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o OTHER <br /> <br />o GAS o ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLOO~ ELEVATIONS <br /> <br /> <br />BUILDER . <br />SIGNA;O~ <br /> <br />ELECTRIC:J:J\N <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />Ml!:CHANJ:CAX. <br /> <br />SIGNATURE <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHE:R <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~O <br /> <br />STATE CERT OR REGIST j C/3C/ZSlrf41- <br /> <br />******.***.~*******.*..***.****.****~ <br /> <br />COMPANY ~S~ <br /> <br />P4SLo <br /> <br />~~'c <br />~ RoO t Lfsct' <br /> <br />STATE CERT OR REGIST i <br /> <br />l)" \I)-.{ Lo II j<o pI J M ~ l" t <br />STATE CERT OR REGIST # ere l + d- (.;)-<1 <br /> <br />COMPANY <br /> <br />* ***********************~*:****1b******r.*** <br />. COMPANY. f' "1 S f)i( A ~. - <br />STATE CERT OR REGIST . CA-<:-OS'C Lf( 0 <br /> <br />OTHER <br /> <br />~\i::~""'~""""""~~:~:"~:;;~i;;;;"""'" <br /> <br />SIGNATURE "" . STATE CERT OR REGIST * CC -CoS799 I <br />