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<br />MAR/31/2005/THU 11:40 AM <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />P. 002 <br /> <br />FAX No. 813-780-0021 <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUXLDYNG DEPARTMENT 5335 8~ St, Zuphyrhi11s, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE Rli:CE IVED <br /> <br />OWNER'S NAME IJS ~1W\t. 0'tfef?l~"b,--.- Le..^^otl <br />JOB ADDRESS '11( 31 ~~ /?441/.,.fyV7 .or <br /> <br />PHONE <br /> <br />9;3 -7(/1 -5:1.77 <br />ey..f./(,3$ <br />~t3~ 7(/j' - SJ..-n <br /> <br />LEGAL DESCRIP~IO~: LOT(S) <br />PARCEL ID . <br /> <br />WORK PROPSED: <br /> <br />PROPOSED <br /> <br /> <br />CONSTRUCTION <br /> <br />DSIGN <br />USE~GL FAMILY DWELLING <br />o COMMERCIAL <br /> <br />PHONE CONTACT FOR PEaMITTING <br /> <br /> <br />SUBDIVISION <br /> <br />Cre5fv~\.J Itills <br /> <br /> <br />N <br /> <br />o <br /> <br />o ADDITION <br /> <br />o ALTERATION <br />o DEMOLISU <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o MOVE <br /> <br />OMULTI-FAMILY <br />o INQ.USTRIAL <br /> <br />Of OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />c:J <br />New <br /> <br />sf{( , <br />) <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />'/YlQoIe/: O)t./f,r~ ZOo3 <br />SQUARE FOOTAGE /9 ZO <br /> <br />BUILDING SIZE <br /> <br />nESCRI~:J: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 PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL ,NEW CONSTRUCTION. <br /> <br />M BUILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ /??4 J-//) <br />./.: c;- 0 <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />9f <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />AMP SERVICE <br /> <br />$ <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYPB 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!:CHANJ::CAX. <br /> <br />SIGNATURE <br /> <br />Progress Ene>;gy <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o OTHER <br /> <br />D FRAME <br /> <br />D STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AHEAD YES <br /> <br />~O <br /> <br />STATE CERT OR REGIST . Ci3C /ZS/tf-4l- <br /> <br />*********.************..*.********.***.~ <br /> <br />c::::_~.+ <br />COMPANY ~ J <br /> <br />P4$(O ~e..JD'c <br />€ RoO \ LfSOl' <br /> <br />S~ATE CERT OR REGIST * <br /> <br />COMPANY \)" "'~ Looli'- pl~M\j"t <br />STATE CERT OR R~GIST . CF'C lf~. (,,;}--'1 <br /> <br />*..*..w*****************~*:***;~******r.**,* <br />COMPANY, f' "1 ':> Oil. A '- ' <br />STATE CERT OR REGIST " CAe- OS'O 'f{ (:) <br /> <br />OOHER ~~::~...... ~""""""""':~:~:"~:;;~i;;;;"""'" <br /> <br />SIGNATURE ~' ... - ' STATE CERT' OR REGIST * CC -CoS79<:J I <br />