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<br />MAR/31/2005/THU 11:40 AM <br /> <br />OWNER'S NAME ~1V\t.. G,\r,e[A.~lI..-- - Le...^^otl ' <br />JOB ADDRESS - 115:; /??t:'/"ch~ -71/,/ /~ . &;r , <br />tJ./:2.tJ BLOCK <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..a St, Zephyrhi11.s, FL 33542 <br />813-7BO-0020 FAX:B13-780-0021 <br /> <br />S--/3 ~C'J.:r- <br />DATE Rli:CE rvED <br />9;3 - 7(,/1 - 5:1.77 <br />e'l-J../(,35 <br />?J13':'7~1-S;t.:71 <br /> <br />PHONE CONTACT FOR PEnHITTING <br /> <br />PHONE <br /> <br /> <br />ere 51 v~ \,oJ M;{!$ <br /> <br />PARCEL ID * <br /> <br />LEGAL DESCRIP~IO~: <br /> <br />M <br /> <br />WORK PROPSED: <br /> <br />PROPOSED <br /> <br />SUBDIVISION <br /> <br />RT <br /> <br />N <br /> <br />o ADDITION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSl:GN <br />USE.x;GL FAMJ::LY <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />DMULTI-FAMILY <br />o IND,USTRIAL <br /> <br />Of OF UNITS <br />o SWIMMING POOL <br /> <br />D MOBILE HOME <br />DOTHER <br /> <br />DWELLING <br /> <br />CJ RESTAURANT & HEALTH DEPARTMENT APPROVAL 1/ <br /> <br />New sf(( j A/l.ao/e/: ~~c4v:, a:~/'(/ Zt:?03 <br />SQUARE FOOTAGE ZO 7 b HEIGHT <br /> <br />BUILDING SIZE <br /> <br />DESCRI~l:ON 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 srGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED_ <br />PROPERTY SURVEY REQUIRED FOR ALL .NEW CONSTRUCTION. <br /> <br />~ BUILDING <br />o E:LECTRIC:AL <br />o PLUMBING <br />o MECHANICAL <br /> <br />PERMITS REQUESTED <br /> <br />$ /O~Z/D <br />/~~C/ AMP <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W' Progress Ene:r:gy 0 <br /> <br />SERVICE <br /> <br />W_R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLoo~ ELEVATIONS <br /> <br /> <br />BUILDER . <br />SrGNA;O~ <br /> <br />SLECTRICIAN <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />Ml!:CHANXCA:l. <br /> <br />SIGNATURE <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 />STATE CERT OR REGIST . Ci3CIZS-/~4'l, <br /> <br />p~s{c ~dD<: <br />eRoO t ~SOl' <br /> <br />STATE CERT OR REGIST . <br /> <br />COMPANY \)... \IJ-.{ LollI'- PIJM\j,,~ <br />STATE CERT OR REGIST # ere 1 f~. {,d.'1 <br /> <br />............ * *'" "'.. *. * * '" '" "'.... * *~'\* ** **l-b*"'*"'**r. * *.* <br />COMPANY. f' "1 S (}lL A <.... . <br />STATE CERT OR REGIST . C-A<- 05'0 Lf( (:) <br /> <br />OTlIER <br /> <br />~~~~.... .~... .... ..... .~~~:::.:. 'C: 5r:;i;;'~'" ...... <br /> <br />SIGNATURE '" ' STATE CERT OR REGIST it C C - Co S 799 I <br />