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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 ZEPHYRHILLS PERMIT APPLICATION <br />BUILDTNG DEPARTMENT 5335 8"a St, ZOiIphyrhi11.s, l!"L 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE ~CEIVED <br /> <br />Le..A^otl <br />6 -,,, <br /> <br />9;3 - 7~9 -5:1.77 <br />e'l-J..lil3$ <br />'D13 -~ 7 ~1- 5;;L f) <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />OWNER'S NAME IJS r\o~ G,~fl}f^~llr-- - <br />JOB ADDRESS . '1 'l?> , ~'r.h,4YJ rVi/k <br /> <br />PHONE <br /> <br />BLOCK <br /> <br />SUBDIVISION CresfVf-e\,J ltill5 <br /> <br />PARCEL ID * <br /> <br />LEGAL DESCRIPTIO~: LOT{S) <br /> <br />N <br /> <br />WORK PROPSED, <br /> <br />PROPOSED <br /> <br /> <br /> <br />7--0Z60 <br /> <br />o ADDITION <br /> <br />o MOVE <br /> <br />o ALTERATI ON <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DSrGN <br />USB~GL. FAMILY <br />o COMMERCIAL <br /> <br />DMOLTI-FAMILY <br />o I Nl:\USTRIAL <br /> <br />o If OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBrLE HOME <br />o OTHER <br /> <br />DWELLING <br /> <br />C::J <br />/Jew <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />A/1~/: OYhr:q!' zco.3 <br />SQUARE FOOTAGE /720 <br /> <br />sf(( , <br />) <br /> <br />BUILDING SIZE <br /> <br />J:>ESCRI1>T:I:ON OF WORK <br /> <br />HEIGHT <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 PERM~T ONLY (2) SETS OF ENGINEERED PLANSREQOIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL .NEW CONSTRUCTION. <br /> <br />~ BUILDING <br />o ELECTRICAL <br />o PLuMBING <br />o MECHANICAL <br /> <br />PE~TS REQUESTED <br /> <br />$ /O~ y/O <br />/.s- 0 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W' <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />Progress Ene>::gy <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 />TYP~ OF CONSTRUCTION~BLOCK <br />FINISHED FLOOR ~L~VATIONS <br /> <br /> <br />BUILDER <br />SIGNA;UtE <br /> <br />ELECTRICIAN <br /> <br />SIGNATUR~ <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />Hl!:CHAN:rCAX. <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 t CI3C/ZS/~4'l- <br /> <br />***.***********.*******.*...**.****.****~ <br /> <br />COMPANY D~'+ P<l\~lo ~e..JDc <br />..;- RoO t Lf SOl' <br /> <br />STATE CERT OR REGIST t <br /> <br />****~**********.*.*...********.*************** <br /> <br />COMPANY!)" \/J-.{ Lo \I ~ pI J '" ~ L, e. <br />STATE CERT OR REGIST It ere l4~ (,;;).-"1 <br /> <br />.*************..******~*:.***~******r.**.* <br />COMPANY. Pi "1 OS f)~ A ~ . <br />STATE CERT OR REGIST It c.A-<:-os-o Ltc 0 <br /> <br />~R ~~~""'~""""""':~:~:"~:;;~i;;;;"""'" <br /> <br />SIGNATURE ~..-~ ~~ STATE CERT OR REGIST * C. C - Co S 7 9 <j I <br />