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<br />MAR/31/2005/THU 11:40 AM ZEPHYRHILLS BUILDING FAX No, 813-780-0021 <br /> <br />CITY OF ZEPBYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 e"a St, Z&phyrhi,11s, l!"L 33542 <br />813-780-0020 VAX: 813-780-0021 <br /> <br />P.002 <br /> <br />DATE Rli:CEIVED <br /> <br />OWNER'S NAME~1V\t. G,\fCfA.~llr- - Le..A^qj <br />JOB ADDRESS '7(1::2) 4h~h/'Ht/ /;-,n ~r <br /> <br />PHONE <br /> <br />fjiJ - 7(,9 - 5;1..77 <br />e'f-f.'Gt3$ <br />'bl3 -~ 7 ~'~j' - 5:l..-n <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />PARCEL ID * <br /> <br /> <br />Z/- '>'>5' <br /> <br />t? <br /> <br /> <br />Cre s I vr-e i.J II,' 1/5 <br /> <br />LEGAL DESCRIPTIO~: LOT{S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />N <br /> <br />WORK PROPSED, <br /> <br />o ADDITION <br /> <br />o ALTERATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED <br /> <br />OSIGN <br />USE~GL FAMILY <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />DWELLING <br /> <br />DMOLTI-FAMILY <br />o IND,USTRIAL <br /> <br />Of OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />DESCRIP'J!XoN OF WORK <br /> <br />C::J <br />New <br /> <br />RESTAURANT " HEALTH DEPARTMENT APPROVAL <br /> <br />'A/1qc/e/: Cv/4~'1,a/~z:h <br /> <br />SQUARE FOOTAGE 2076 <br /> <br />sf-{( , <br />) <br /> <br />Zoo _OS; <br /> <br />BUILDING SIZE <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 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 />o PLUMBING <br />o MECHANICAL <br /> <br />PERMITS REQUESTED <br />$ /L?~ 2/0 <br /> <br />,/ .>0 AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />~. <br /> <br />Progress Energy <br /> <br />o <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 />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLOO~ ELEVATIONS <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />D OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />~O <br /> <br /> <br />'BUILDER ' <br />SIGNA';otE <br /> <br />STATE CERT OR REGIST . Cf3C/ZS/r/4.l- <br /> <br />SIGNATURE <br /> <br />.*-*******..******.*********************.**~****.*.*********.****~ <br /> <br />~ . COHOANY 80s./. P"5lo ~c <br />.:. ........ ..................... .::~:~.~::.:~ .~~:::: .:...~.~~~: 'i S"I' <br /> <br />:ELECTRICIAN <br /> <br /> <br />COMPANY <br /> <br />t)1-\ V}~ <br /> <br />PLOMBER <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />OTHER <br /> <br />~~~...... .~.... .... .::~:;:,~.. c.. 5~D;;"""'" <br />SIGNATURE STATE CERT OR REGIST * CC -CoS799 I <br />.......- <br />