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<br />MAR/31/2005/THU 11 :40 AM <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <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 8~a St, Z...phyrhill.a, l!"L 33542 <br />613-780-0020 FAX: 813-780-0021 <br /> <br />DATE RECEIVED <br /> <br />IJ S t\o fI\t. Co ~ f l) (4l~ 11 r-- - <br />71S')~rch~;/v//k <br /> <br />fji 3- 7(PCJ - 5:1.77 <br />e..,.f.lf635 <br />~13 -~ 7(/i - 5;t-n <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />Le..A^ot.l <br />C.~. <br /> <br />PHONE <br /> <br /> <br />BLOCK <br /> <br />C te 5/ vrt \,.I IIi lh <br /> <br />PARCEL IO it <br /> <br />LEGAL OESCRIPTIO~: LOT(S) <br /> <br />N <br /> <br />WORK PROPSED: <br /> <br />PROPOSED <br /> <br />SUBDIVISION <br /> <br /> <br />()> <br /> <br />RT <br /> <br />M <br /> <br />o AODITION <br />o MOVE <br /> <br />o ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />CONSTRUCTION <br /> <br />DSIGN <br />USE~GL. FAMILY <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o IN~USTRIAL <br /> <br />Of OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />DOTHER <br /> <br />DWELLING <br /> <br />[=:J <br />/Jew <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />. A/J.QOIe/: .4/7 c/o. t.;' t' / <br />SQUARE FOOTAGE Z ~/ b <br /> <br />sf (( . <br />) <br /> <br />_ ZOOS- <br /> <br />BUILDING SIZE <br /> <br />OESCRII?'.rION 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 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 />$ /z~/ 6S---6 <br />Z.oo <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W' <br /> <br />o <br /> <br />AMP SERVICE <br /> <br />Progress Energy <br /> <br />W.R.E,C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLoo~ ELEVATIONS <br /> <br /> <br />BUILDER <br />SIGNA;OtE <br /> <br />ELECTRICIAN <br /> <br />SIGNATORE <br /> <br />~OHBER <br /> <br />SXGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />o OTHER <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 />STATE CERT OR REGIST t Ci3 c / zs / rl-4- L <br /> <br />*.****** *~***~*.*****.******~....***.***.****.. <br /> <br />/peg COMPANY ~5~ P4~lo ~~'c: <br /> <br />_~ - STATE CERT OR REGrST' eRoOI'IS"\1 <br /> <br />***...**w****** *******~*************.*..************t*********** <br /> <br /> <br />COMPANY \)" Vl-.l, Lo,,~ Ploll'\\"~ <br />STATE CERT OR REGIST ~ e F'C l ~~. (d-"1 <br /> <br />***********************~~*:****lb******r.*** <br />COMPANY. f' "1 s ()~ A '-. . <br />STATE CERT OR REGIST it CA<-OS""O 4c (:) <br /> <br />~~~""~"'---""'--"':::p::::"~:;;~i;;;;""'-'" <br /> <br />SIGNATURE ,,_u 0 STATE CERT OR REGIST t. C C ~ Co S 7 9 <1 I <br /> <br />OTHER <br />