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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 />BU~LDING DEPARTMENT 5335 8- St, ZQphyrhi11s, FL 33542 <br />813-780-0020 HAX:813-780-0021 <br /> <br />t\o~ G,tfCf^~llr- - Lf.-A^otl ' <br />~"-r-'h~/j///k . [?/'y <br /> <br />DATE Rli:CEIVED ~----13-o.5- <br />9,3 -7(.,<1 -5:1.77 <br />e'f--i./(,3$ <br /><f!t3:"7~1' -5;t/> <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />PHONE <br /> <br />OWNER'S NAME I)S <br />JOB ADDRESS f7tJ1/ <br /> <br />C r-e 5f V~ i-J /-J;tl $ <br /> <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID It <br /> <br />LEGAL DESCRI~TIO~: <br /> <br />N <br /> <br />WORK PROPSED: <br /> <br />PROPOSED <br /> <br /> <br />o ADDITION <br /> <br />o ALTERATION <br />o DEMOLISll <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSLGN <br />USB~GL. FAMILY <br />OCQMMERCIAL <br /> <br />o MOVE <br /> <br />DWELLING <br /> <br />DMULTI-FAMILY <br />o INo,USTRIAL <br /> <br />Of OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />DOTHER <br /> <br />c=J RESTAURANT <br />eW sf{(' <br /> <br />Ii< HEALTH ~EPARTMENT AP ROVn ,t? <br /> <br />, t?':1 (2L~~ <br /> <br />SQUARE FOOTAGE ZO 7 b <br /> <br />2CCJ 3 <br /> <br />BUILDING SIZE <br /> <br />DESCRIP'J:J:ON 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 /> <br />$ ,/O~/Z/D <br />,/S V AMP <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W' Progress Energy 0 <br /> <br />W.R_E.C, <br /> <br />SERVICE <br /> <br />$ <br /> <br />VALUATLON OF MECHANCIAL INSTALLATION <br />D OTHER <br /> <br />o GAS 0 ROOFING D SPECIA1.TY <br />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLOO~ ELEVATIONS <br /> <br /> <br />BUILDER . <br />SIGNA;otE <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />Ml!:CHAN~CAX. <br /> <br />SIGNATURE <br /> <br />D FRAME <br /> <br />D STEEL <br /> <br />o OTHER <br /> <br />~O <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />STATE CERT OR REGIST' C15c/zS/~4'l- <br /> <br />~4~l.c ~eJp(: <br />e RoO 1 LfSOl' <br /> <br />STATE CERT OR REGIST t <br /> <br />*-~*.***~**********.*****.*.**************** <br /> <br />=MPANY I)... V)~ Lov!" pl~M\!"f <br />STATE CERT OR REGIST It ere l~ ~ (d"1 <br /> <br />** **** *..******....*.. """ *~*,... ""11>******(.**.* <br />. COMPANY. f' "1 s f)~ A <.... - <br />STATE CERT OR REGIST .. c.A<-O,S-O tf( 0 <br /> <br />~R ~~::~............... .... ~::::.. ~: 5b{i;; ~.. .... ... <br /> <br />SIGNATURE ~.. STATE CERT OR REGIST i CC -CoS7 9 Cj I <br />