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<br />AR/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, ZQphyrhi11s, l!"L 33542 <br />813-7BO-0020 VAX:B13-780-0021 <br /> <br />DATE Rli:CE IVED <br /> <br />Le.f\^oc.1 <br />~))-' <br /> <br />fiB - 7~CJ - 5:1.77 <br />ey.././G.35 <br />?ll3 -~ 7&1- 5.2..71 <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />O",,"&R'S NAME u~~ c.,rf.rJ1>~ - <br />JOB .ADDRESS ~.kC':~~? <br /> <br />PHONE <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />C te 5>/ vlt i,J 1-/; II $ <br /> <br /> <br />WORK PROPSEO; <br /> <br />PROPOSED <br /> <br />-0 <br /> <br /> <br />N <br /> <br />M <br /> <br />RT <br /> <br />CONSTRUCTION <br /> <br />DADDITION <br /> <br />o ALTERAT IoN <br />D DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br />USE~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />DMOVE <br /> <br />DHOLTI-FAMILY <br />o INo.USTRIAL <br /> <br />o If OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />DOTHER <br /> <br />C::J <br />}Jew <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />A/1qole/: O%/br:c;( ZtA7:S <br />SQUARE FOOTAGE./9 Z-o <br /> <br />sf(( . <br />) <br /> <br />BUILDING SIZE <br /> <br />DESCRI~:loN OF WORK <br /> <br />HEIGRT <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 />~ BUILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />PERMITS REQUESTED <br />$ /t? ~ Y/t/ VALUATION OF TOTAL CONSTRUCTION <br />//~O AMP SERVICE ~'. Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAS 0 ROOFING D SPECIALTY <br />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLOO~ ELEVATIONS <br /> <br />o FRAME <br /> <br />o OTHER <br /> <br />D STEEL <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~o <br /> <br /> <br />BUILDER <br />SIGNA;utE <br /> <br />ELECTRIC:lAN <br /> <br />SIGNATURE <br /> <br />l"LOMBER <br /> <br />SIGNATURE <br /> <br />Ml!:CHANJ:CAX. <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST . CI3C /ZS/s'4.Z- <br /> <br />.*****************~******~*.************.*******.*...************- <br /> <br />/..//)::J7--, COMPANY 8t~~ p~S(O ~e.J.p'c <br /> <br />_~~~ STATE CERT OR REGIST it ~RootLfSOl' <br /> <br />.*.*...************ ****.****~*******.**********.****.*******.*** <br /> <br /> <br />COMPANY b" vi LOlli'- plol""~'\"~ <br />STATE CERT OR REGIST # CF'C l~d- (,;}-'1 <br /> <br />***..*********..******~*:..**r;*.*.**r.*** <br />. COMPANY. f' "1 'S I)te A <...... ~ <br />STATE CERT OR REGIST # CA<-- 05'0 LtC c <br /> <br /><nHER ~~~~WH"" ~H'''''''::;~:''~:5~{;;'~'''''W' <br /> <br />SIGNATURE ~ STATE CERT' OR REGIST . CC ~CoS7991 <br />