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<br />V~R/31/2005/THU 11:40 AM <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />FAX No. 813-780-0021 <br /> <br />p, 002 <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BU'ILD'ING DEPARTMENT 5335 8"B St, ZQphyrhi.11s, J!"L 33542 <br />813~7BO-o020 FAX: 813-780-0021 <br /> <br />DATE Rli:CE IVED <br /> <br />liS ~~ CA-;j;^~"~ - <br />'7v ~ . /~!' V~rP7 <br /> <br />9;3 -7&9 -5;1.77 <br />ey..-I./(,3S <br />'l!n ~~ 7 &1' - S.l.. 71 <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />Le..A^C\.I <br />~f <br /> <br />PHONE <br /> <br />SUBDIVISION Cte5fvf-eirS ,.1;[/$ <br /> <br /> <br />PARCEL ID * <br /> <br />WORK PROPSEO: <br /> <br />PROPOSED <br /> <br />RT <br /> <br />N <br /> <br />o ADDITION <br /> <br />o ALTERAT ION <br />o DEMOLISll <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />OSIGN <br />USE~GL FAMILY <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />DWELLING <br /> <br />DMULTI-FAMILY <br />o IND,USTRIAL <br /> <br />Of OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c=:J <br />}Jew <br /> <br />RESTAURANT & HEALTH DEPARTMENT AP~ROV~~ <br /> <br />sfR.. j A/J~c/e/: 8/"/.>r~~ <br />"7.2 r~ - <br />SQUARE FOOTAGE C-- c:r ~ HEIGHT <br /> <br />ZCO -~ <br /> <br />BUILDING SIZE <br /> <br />DESCRI~rON OF WORK <br /> <br />RESIDENTIAL:. ATTACH (2) PLOT PLANS & {2l 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 ELECTRI:CAL <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ /ZO, OrYb <br />/ <br /> <br />/~O AMP <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />i}(' Progress Energy 0 <br /> <br />W.R.E.C, <br /> <br />SERVICE <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />ELECTRICXAN <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />Ml!:CHAN'ICAX.. <br /> <br />SIGNATURE <br /> <br />o OTHER <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 />COMPANY <br /> <br />8t~A- <br /> <br />~(; <br />e Roo, 4.fSOl' <br /> <br />P4l\~lo <br /> <br />STATE CERT OR REGIST t <br /> <br />l'l" "'-.{ Levy- plolM\L.f <br />STATE CERT OR REGIST . e ~c lof: d {d-'1 <br /> <br />COMPANY <br /> <br />- w.................... **................. *~*,*.... *'*l-i,**** *'*(. '* -.* <br />COMPANY. Pi "'1 '::> {)i( A ~ . <br />STATE CERT OR REGIST it c..A-C- 0.5"0 4c 0 <br /> <br />OTHER <br /> <br />~~;:~"""'~""""""~~~:~:"~:;;~i;;;:"""'" <br /> <br />SIGNATURE ,,~ STATE CERT OR REGIST * C c - Co S 799 I <br />