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<br />MAR/31/2005/THU 11:40 AM <br /> <br />ZEPHYRHILLS BUILDING FAX No. 813-780-0021 <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8%8 St, Zuphyrhill.s, FL 33542 <br />813-780~0020 li"AX; 613-780-0021 ..::::-_"! -:7.- .J _ <br />DATE R:zCEIVED...# ,_? ~,:J <br /> <br />fli 3 - 7(P<j - 5;1.77 <br />ey..-I-./il3$ <br /> <br />'D'3-~7(,1-S~Y> <br /> <br />P. 002 <br /> <br />PHONE CONTACT FOR I?ERMITTING <br /> <br />tiofi\t. G, c: r t~"br-- - Lf.-f\AoU : <br />/77C'rc0~,h'l/k C/r <br /> <br />OWNER'S NAME <br /> <br />US <br />JOB ADDRESS' '7~ 53 <br /> <br />PHONE <br /> <br />BLOCK <br /> <br />C r-e 5/ vrt \,oS If; tJ ~ <br /> <br />PARCEL ID * <br /> <br />LEGAL DESCRI~TIO~: LOT(S) <br /> <br />N <br /> <br />WORK PROPSED: <br /> <br />PROPOSED <br /> <br />SUBDIVISION <br /> <br /> <br /> <br />Ot <br /> <br />RT <br /> <br />CONSTRUCTION <br /> <br />o ADDITION <br />o MOVE <br /> <br />o l\LTERAT ION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSIGt'l <br />USE~GL. FAMILY <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o I Nl:\USTRIAL <br /> <br />Of OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />DOTHER <br /> <br />DWELLING <br /> <br />c=J RESTAURANT.&HEALTH DEPA~~P~L <br />/Jew sfR j A/lqc/e/: t/ /0 Z//. -" ceo 5: <br />C;' . <br />SQUARE FOOTAGE /7' ZO HEIGRT <br /> <br />BUILDING SIZE <br /> <br />DESCRII?Tl:ON OF WORK <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLAt'lS & (1) SET ENERGY <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 /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />t./ r;; J :;.. <br /> <br />PERMITS REQUESTED <br />$ /v~(P/O <br />/, <br />,~ Q; AMP SI!:RVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W' <br /> <br />o <br /> <br />Progress Energy <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 />TYPI!: OF CONSTRUCTION~BLOCK <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />BUILDER <br />SIGNA;U~ <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />~QMBER <br /> <br />SIGNATURE <br /> <br />MECHANICAL <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 I CJ3CIZS-/~4"l.. <br /> <br />COMPANY \')" wl. Lolli'- PI"M~l..[ <br /> <br />STATE CERT OR REGIST ~ ere l4= ~ {.;)-<1 <br /> <br />**..*.********..***...*~.:****1b**.W**(,**. <br />COMPANY. f' "1 s ()~ A <--. " <br />STATE CERT OR REGIST it CA<--OS"O tf( 0 <br /> <br />O"l'lIER <br /> <br />~~::~"~""""""":::::~:"~:;;~i;;;;"""'" <br /> <br />SIGNATURE "", .. STATE CERT OR REGIST * C <: - Co S 799 I <br />