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<br />~/31/2005/THU 11:40 AM <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />FAX No. 813-780-0021 <br /> <br />P. 002 <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 BYB St, Z...phyrhi11s, l!"L 33542 <br />813-780-0020 VAX:813-780-0021 <br /> <br />DATE Rli:CE IVED <br /> <br />IJS t\olW\t. G,tfl}~~llr- - Le.A^oU <br />111/"Czk~h~K"'~ L>r <br /> <br />9'5 -7(,1 -5:2.77 <br />e..,.J.. /(,3$ <br />'l! t3 -~ 7 ~ 1 - .5 ;L 71 <br /> <br />J?ltONE CONTACT FOR PEltHITTING <br /> <br />PHONE <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />C te 5{ V~ i,J I-/-i iI $ <br /> <br />pARCEL ID * <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />M <br /> <br />RT <br /> <br />WORK PROPSEO; <br /> <br />PROPOSED <br /> <br /> <br /> <br />-..>..>..>s -00000- 0, <br /> <br />N <br /> <br />o ADDITION o ALTERATION o REPAIR o INSTALL <br />o MOVE 0 DEMOLISH <br />DMULTI-FAMILY Of OF UNITS o MOBILE HOME <br />o INC\USTRIAL o SWIMMING POOL DOTHER <br /> <br />CONSTRUCTION <br /> <br />DSIGN <br />USE~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />C:J <br />New <br /> <br />RESTAURANT k HEALTH DEPARTMENT APPROVAL <br /> <br />. MQoIe/: ~,4;;~/ ZCD '37,. <br />/' C? 7. r-, <br />SQUARE FOOTAGE L_L c..-f./ <br /> <br />sf (( . <br />) <br /> <br />BUILDING SIZE <br /> <br />OESCRIP"J::J:oN 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 />M BUILDING <br />o ELECTRICAL <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ /(;?~ y/'O <br />-<-S;-O AMP <br />, . <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W'. Progress Energy 0 <br /> <br />W.R.E.C, <br /> <br />SJ;:R:VICE <br /> <br />$ <br /> <br />VALUATION 6F MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAs DROOFING D SPECIALTY <br />TYPJ;: OF CONSTRUCTION~BLOCK <br />FINISHED FLOO~ ELEVATIONS <br /> <br /> <br />BUILDER . <br />SIGNA;O~ <br /> <br />:ELECTRICX.AN <br /> <br />SIGNATURE <br /> <br />In.OHBER <br /> <br />SIGNATURE <br /> <br />MECHANICAX. <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 />STATE CERT OR REGIST I C.l3C / zs- / rf-4 Z- <br /> <br />**~*******************.*..************.* <br /> <br />~ - ~.+ <br />COMPANY ~J <br /> <br />P45(O ~e..J.r,'c <br />e Roo, LfSOl' <br /> <br />STATE CERT OR REGIST . <br /> <br />COMPANY l)... \I)-.{ Lov}" pIVM~lA~ <br />STATE CERT OR REGIST " CF'C l{~ ld"1 <br /> <br />.. **...* * * *** ** * **... * * *.. * * ~..,.... * * ;1-i;*** **f" "," <br />. COMPANY. Pi "1 ':::> Of(, A '- . <br />STATE CERT OR REGIST " CA-C--oS-O 'f< (:) <br /> <br />OTHER ~~::~......~..............~~~:~;..~:;;~[;;;;......... <br />SIGNATURE ~. .' STATE CERT OR REGIST It CC -CoS799/ <br />V'" - <br />