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<br />MAR/31/2005/THU 11:40 AM <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />FAX No. 813-780-002! <br /> <br />P.002 <br /> <br />CITY OF ZEPBYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aYB St, Zuphyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE Rli:CE IVED <br /> <br />us tio~ LctrerJ"br-- - <br />7U"^~~..... h.<9'~/"c-l'n <br /> <br />9'5 - 7(// - 5:1.77 <br />eyJ 1(,35 <br />'D 13 ..~ 7 (/1 - .5 .2.:71 <br /> <br />PHONE CONTACT FOR PEPHITTING <br /> <br />Le..A^atJ <br />"Dr <br /> <br />cre5fvrti,J Itill$ <br /> <br />PHONE <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID * <br /> <br />LEGAL DESCRIPTIO~: LOT(S) <br /> <br />H <br /> <br />WORK PROPSEO, <br /> <br />PROPOSED <br /> <br /> <br />~o /17 <br /> <br />-'C), <br /> <br />RT <br /> <br />N <br /> <br />o ADDITION <br /> <br />o ALTERAT ION <br />o DEHOLISll <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGN <br />USE~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />o HOVE <br /> <br />DMULTI-FAMILY <br />o INQ,USTRIAL <br /> <br />Of 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/1Q01'e/: O,x-r::br/ ZOO.5 <br />. , <br /> <br />SQUARE FOOTAGE /9Zc;> <br /> <br />sfR, <br />) <br /> <br />BUILDING SIZE <br /> <br />DESCRIPTXON 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 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 />PERMITS REQUESTED <br /> <br />$/??~' P/O <br />./. S- t? AMP SI!:RVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />9f <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />Progress Energy <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPI!: OF CONSTRUCTION~BLOCK <br />FINISHED FLOO~ ELEVATIONS <br /> <br /> <br />BUILDER . <br />SIGNA;OiE <br /> <br />ELECTRIC:D\N <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />SXGNATURE <br /> <br />MECHANICAl.. <br /> <br />SIGNATURE <br /> <br />OTHER <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 t Ci3C /Z.S/r/-4L <br /> <br />*********-****.*********..***********.** <br /> <br />COMPANY ~-s~ P4.5l.o <br /> <br />~~'c <br />e RoO 1 'I SOl , <br /> <br />STATE CERT OR REGIST . <br /> <br />COMPANY l)... vlJ. Lolli'- plJM\lAe <br />STATE CERT OR REGIST ~ cF'C l+~ (d-"1 <br /> <br />... *..... * *..*'*........ **..... '* * *~,o -::" * '* "'~"'l-b ........ * ,or. .. ,o.* <br />. COMPANY. f'''1 '::::> f)~ A '- . <br />. STATE CERT OR REGIST it CA<-OS"O Ltc 0 <br /> <br />~\i"1 <br /> <br />~""""""'::~;~:"~:;;~i;;;;"""'" <br />_ .. STATE CERT OR REGIST It CC -CoS799 I <br />/" <br />