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<br />MAR/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 ZEPBYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8"0 St, Z..,phyrhi.11.s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE Rli:CE IVED <br /> <br />Le..A^OI..1 <br />LJr <br /> <br />9;3 - 7{Pf} -5;1.77 <br />e"fJ./l43$ <br /><[,*3 -~ 7&1- 5J..-n <br /> <br />Ii'HONE CONTACT FOR Ii'EPHITTJ:NG <br /> <br />owNER'S NAME 1)5 tlolV\t.. CotfG~~lI.,-. <br />JOB 1\DDRESS '7u/~ ~Ghffh/~~P? <br /> <br />PHONE <br /> <br /> <br /> <br />N <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />1/; II $ <br /> <br />PARCEL ID it <br /> <br />LEGAL DESCRIPTIO~: <br /> <br />WORK PROPSEO: <br /> <br />PROPOSED <br /> <br />CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERAT IoN <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />OSIGN <br />USE~GL. FAM1LY <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />DMULTI-FAMILY <br />o INo..USTRIAL <br /> <br />o It OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />DOTHER <br /> <br />DWELLING <br /> <br />c=J RESTAURANT & HEALTH DEPARTMEN: ~PROV~ ~ <br />New sf(( j L1/1qole/: ~kk.f? ~#C; Z003 <br /> <br />SQUARE FOOTAGE z,CJ 76 HEIGHT <br /> <br />BUILDING SIZE <br /> <br />DESCRI~XON OF WORK <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 />o PLUMBING <br />o MECHANICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ /09> 2/0 <br />/' ~ 0 AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W' <br /> <br />o <br /> <br />W.R.E.C, <br /> <br />Progress Energy <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 /> <br />BUILDER . <br />SrGNA;O~ <br /> <br />ELECTRIC:r.AN <br /> <br />SIGNATURE <br /> <br />1i'L0000R <br /> <br />SIGNATURE <br /> <br />Ml!:CHANICAL <br /> <br />SIGNATURE <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />D OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~O <br /> <br />STATE CERT OR REGIST # <br /> <br />..******* <br /> <br />*.***.**.****.******~..*...****.**.***.~ <br /> <br />~-"'.+ <br />COMPANY ~~ <br /> <br />P<l\~Lc ~e.J;i(: <br />e RoO 1 LfSOl' <br /> <br />~ <br /> <br /><./ <br /> <br />**************************************.*.*************~*'k*****.*** <br /> <br />STATE CERT OR REGIST . <br /> <br /> <br />COM_ANY \)" \11-.( Lov~ pj"M~l,,~ <br />STATE CERT OR REGIST ~ e F'c l4 ~ (.;).'1 <br /> <br />***.*****************~*:****1b***.**r.**.* <br />COMPANY. f' "1 S 012 A <.... . <br />STATE CERT OR REGIST .. C-A<-OS"O If! (:) <br /> <br />OTHER <br /> <br />~r".~'~W"4""" ..... .~::.:;:,:. 'C: ;'F;;L:~ ~...... ... <br /> <br />SIGNATURE V"~ - STATE CERT OR REGIST t CC -CoS799 / <br />