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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 ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8"8 St, Z...phyrhi11.s, l!'L 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE Rli:CE IVED <br /> <br />Ll-A^"-l <br />L;r-- <br /> <br />fji3 -7&9 -5;1.77 <br />ey..-I-./(,3$ <br />~13~7(/i - 5~-n <br /> <br />PHONE CONTACT FOR PE~ITTl:NG <br /> <br />OWNER'S NAME <br /> <br />lJS t\o~ G,\fll~~"br-- - <br />JOB ADDRESS ;7'13 5 ~'/ I" ~ ~ 7'v / d- <br /> <br />PHONE <br /> <br /> <br />BLOCK <br /> <br />Cre 5/ vre \,J 1-1>' 1I $ <br /> <br />pARCEL ID * <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />N <br /> <br />WORK PROPSED: <br /> <br />PROPOSED <br /> <br />SUBDIVISION <br /> <br />&> <br /> <br />-0' <br /> <br />H <br /> <br />RT <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 FAM1LY <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INo.USTRIAL <br /> <br />Of OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DWELLING <br /> <br />c=J RESTAURANT & HEALTH DEPARTMENT APPRO~L ~ <br /> <br />Ale IN sf (( j .LJ/1~/: 8//. s:* I 6?/'~PP"c ZOo ~ <br />SQUARE FOOTAGE Z- Z 6-:-'9" HEIGHT <br /> <br />BUILDING SIZE <br /> <br />OESCRIPT:ION OF WORK <br /> <br />RESIDENTIAL:. ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SrGN PERMIT 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 />& (1) SET ENERGY FORMS, <br />FORMS. <br /> <br />PERMITS REQUESTED <br /> <br />If if 350 <br /> <br />$/Z~ O~h <br />/, -S-O AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />~. <br /> <br />o <br /> <br />Progress Ene:r:gy <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLOO~ ELEVATIONS <br /> <br /> <br />ELECTRICXAN <br /> <br />SIGNATURE <br /> <br />PL~R <br /> <br />SIGNATURE <br /> <br />HECHANICAt.. <br /> <br />SIGNATURE <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 /> <br />***~*****~***~***.******~..*.********.***.. <br /> <br />COMPANY D$..l- P45l.o ~e..JD(: <br />~RoO t Lfsq, <br /> <br />~w-- <br /> <br />STATE CERT OR REGIST . <br /> <br />*****....**.************w*************+...********************.**w <br /> <br /> <br />=M.PANY I).... Vj.{ Lov!" pIJM\"'~ <br />STATE CERT OR REGIST # CF'C l-t:~. (d-Cf <br /> <br />***********************~*~****fb******r*** <br />COMPANY. f' "1 S niL A <.... . <br />STATE CERT OR REGIST . c..A<:- e>S""o iff (:) <br /> <br />OTHER <br /> <br />~~;:~""~""""'."'.':~:~:.'~:;;~i;;;:"""*" <br /> <br />SIGNATURE " STATE CERT OR REGIST * C C - Co S 7 9 9 I <br />