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<br />MAR/31/2005/THU 11:40 AM ZEPHYRHILLS BUILDING FAX No. 813-780-0021 <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUJ:LDING DEPARTMENT 5335 8"8 St, Z...phyrhi.11.B I l!'L 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />P.002 <br /> <br />DATE Rli:CE IVED <br /> <br />OWNER I S NAME US <br />JOB ADDRESS 1 f.t () .1) <br /> <br />tio~ G,r;fDfA~"lIr- - Le..f\^qj <br />~c""~h/Ht/~("'p? ~r:. <br /> <br />PHONE <br /> <br />9i3 - 7(// - 5;1.'77 <br />ey..-I-./(,3$ <br />~'3:'7(/i - 5~71 <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />SUBDIVISION ere 5>/ vrt \,J 1-h'//5 <br /> <br />PARCEL ID * <br /> <br /> <br />BLOCK <br /> <br />--0 <br /> <br />M <br /> <br />RT <br /> <br />N <br /> <br />WORK PROPSEP: <br /> <br />o ADDITION <br /> <br />o ALTERATION <br />o DEMOLISlI <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED <br /> <br />OSIGN <br />USE~GL. FAMILY <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />DWELLING <br /> <br />DMOLTI-FAMILY <br />o IN~USTRIAL <br /> <br />Of OF UNITS <br />o SWIMMING POOL <br /> <br />o HOBILE HOME <br />DOTHER <br /> <br />~ RESTAURANT "', HEALTH DEPARTMENT ~ROV~/ //, . <br />!Jew sfR. j A/1~/: ,8r/s . / bL~7~ <br /> <br />SQUARE FOOTAGE 2- Z G-C/ HEIGHT <br /> <br />zco> <br /> <br />DESCRIP'.rXON OF WORK <br /> <br />BUILDING SIZE <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 />$ /20 c:7cY6 <br /> <br />,/...s:-o AMP SERVICE <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W' <br /> <br />Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <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 />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 />SIGNATURE <br /> <br />~~et:#L- <br /> <br />COMPANY <br /> <br />8t~~ <br /> <br />p<\~(O ~~'c <br />e Roo, LfSOt' <br /> <br />:ELECTRIC:J:AN' <br /> <br />STATE CERT OR REGIST . <br /> <br />PLUMBER <br /> <br />****.**.-.****************************.**************~************ <br /> <br /> <br /> <br />...:~~ ........... .::~~~:~~:~~~(;.:;.~C~~~(d~ <br /> <br />yo COMPANY f''''1 '"2>._()~ A_~ <br />STATE CERT OR REGIST . C-A<-- oS"o Lf( 0 <br /> <br /> <br />SIGNATURE <br /> <br />Ml!:CHANJ:CAX. <br /> <br />SIGNATURE <br /> <br />OT~" ~~:~. "H~"'"'' ...:;~:::..c: ;;[-:;i,:;~". ...... <br /> <br />SIGNATURE _. STATE CERT OR REGIST It CC~CoS79<J1 <br />