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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 APPLICAT~ON <br />BUrLDING DEPARTMENT 5335 8"8 St, ZOiIphyrhi11.a I FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE Rli:CE IVED <br /> <br />~~ Cc\fe~~ll..-. - Le.-f\^or.l ' <br />/?;/'.....,-;..6~r-y//k. C"r <br /> <br />9/3 - 7(.,9 - 5:2.7] <br />e..,..J.I1435 <br />'D 13~ 7 t, 1 - .5 ;/.:71 <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER I S NAME lJ S <br />JOB ADDRESS 1) '7 O'l <br /> <br />PHONE <br /> <br />BLOCK SUBDIVISION C roe 5>1- vr-e i"J /-li 115 <br /> <br />ZZC> M RT <br /> <br />PARCEL ID it <br /> <br />LEGAL DESCRI~TIO~: LOT(S) <br /> <br /> <br />WORK PROPSED: <br /> <br />PROPOSED <br /> <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />CONSTRUCTION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br />o DEMOLISH <br /> <br />DSIGN <br />USE~GL. FAMILY <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />DMOLTI-FAMILY <br />o INC\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 DEPARTMENT APPROV~L~ ,v <br /> <br />/Jew sfR. j A/1.t;>oIe/:- 6~n(~&/#uc/1!"" Zoo:5 <br />SQUARE FoOTAGE ~~t?L> HEIGHT <br /> <br />BUILDING SIZE <br /> <br />DESCRIP'.rJ:ON OF WORK <br /> <br />RESIDENTIAL:. ATTACH (2) PLOT ~LANS & (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 /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />PERMITS REQUESTED <br />9.~ 7' Y9 VALUATION OF TOTAL CONSTRUCTION <br />,/ ...s--o AMP SI':RVICE i}f Progress Energy 0 <br /> <br />Lf5'W <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />D OTHER <br /> <br />o GAs 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLOO~ ELEVATIONS <br /> <br /> <br />ELECTRIC:I:AN <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />S.rG~ATURE <br /> <br />MECHAN:rCAL <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 />-*0 <br /> <br />********.*.*****.****+**.*.**************~ <br /> <br />~ - ~,} <br />COMPANY ~ J <br /> <br />P45(O ~e.J,i'c <br />eRoo, LfSOl.' <br /> <br />STATE CERT OR REGIST . <br /> <br />COMPANY \)", \1)-.( Looli" pIJM\.l...~ <br />STATE CERT OR REGIST # C. F'C l + d- (.;).Cf <br /> <br />..... *..... * *'" '" "'.* *... '" * *.... *~....... "''''.. .-,.;* * *.... **(. '" *.* <br /> <br />COMPANY. fi "1 S ()~ A ~ ~ <br />STATE CERT OR REGIST it C-A-<:..-OS-O if( (:) <br /> <br />=nEa e-~~' '"Iifj~''' ...... ..... .~~::::.:. 'C: 5~L:;~""''''' <br />SIGNATURE _ STATE CERT OR REGIST * CC -CoS799/ <br />~ - <br />