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<br />MAR/31/2005/THU 11:40 AM ZEPHYRHILLS BUILDING FAX No. 813-780-0021 <br /> <br />CITY OF ZEPBYRHILLS PERMIT APPLICATION <br />BUXLDING DEPARTMENT 5335 aU St, Zuphyrhi11.s, FL 33542 <br />813-780-0020 UAX:813-780-0021 <br /> <br />p, 002 <br /> <br />DATE Rli:CEIVED <br /> <br />OWNER'S NAME <br /> <br />lJS <br /> <br />t\o~ G,\fe~~llr- - Lt:A^qJ , <br />h/c ~ ~.?"-/'~~"., /)r <br /> <br />PHONE <br /> <br />g/J -7('/1 -5;1.77 <br />e'f-f./il3$ <br />'l>13'~ 7(,1- 5;t. 71 <br /> <br />FRONE CONTACT FOR FERMITTING <br /> <br />JOB ADDRESS ~~ CO <br /> <br />LEGAL DESCRIPTIO~: LOT{S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />ere 5/ vrt i-J rh'lI $ <br /> <br />PARCEL ID * <br /> <br /> <br />-Z/-S.>.>~_.~.t? c.O <br /> <br />M <br /> <br />RT <br /> <br /> <br />WORK PROPSED: <br /> <br />CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED <br /> <br />DSIGN <br />USE~GL. FAMILY <br />o COMMERCIAL <br /> <br />D MOVE <br /> <br />o DEMOLISH <br /> <br />DWELLING <br /> <br />DMOLTI-FAMILY <br />o I N[),USTRIAL <br /> <br />o It OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />DOTHER <br /> <br />OESCRI~XON OF WORK <br /> <br />c:J RESTAURANT <br />\?W sf((' <br /> <br />& HEALTH ~EP~RTMENT PPRO;'L R' <br />, t ,l7V1 {2L;;9r/#~ ZOO -S; <br /> <br />SQUARE FOOTAGE 20'76 HEIGHT <br /> <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 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 />$ /t? 7; 2/0 <br />/: 5--0 <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />i)('. Progress Energy 0 <br /> <br />W.R.E.C, <br /> <br />$ <br /> <br />VALUATION 6F MECHANCIAL INSTALLATION <br />D OTHER <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLOO~ ELEVATIONS <br /> <br />o FRAME <br /> <br />D STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~O <br /> <br /> <br />BUILDER <br />SIGNA;otE <br /> <br />STATE CERT OR REGIST It Ci3CIZS/r/4'l. <br /> <br />SIGNATURE <br /> <br />** ****... ;~***** **** *** *::~:::: **i.:~**p:;:; * ~::r:~*.. <br /> <br />JY& STATE CERT OR REGIST it e:; RoO t "SOt , <br /> <br />****....***********w***..*************+...************************ <br /> <br />:ELECTRIC:J:J\N <br /> <br />OTHER <br /> <br /> <br />COMPANY b... \I)~ LoII~ plolM~"'~ <br />STATE CERT OR R~GIST . CF'C if d (.a-<1 <br /> <br />PL~ER <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />*...**.......**** *** *... **........ *~*...:.. **.. *l--b.............*r... ...,... <br />COMPANY. Pi "1 S Oil. A <..... . <br />. STATE CERT OR REGIST " C-A<- 05"0 iff (:) <br /> <br />Ml!:CHAN:I:CAX. <br />