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<br />F~P/?4/2005/THU 09:09 AM ZEPHYRHILLS OOILDI~ <br /> <br />FAX No, 313-780-0021 <br /> <br />p, 001 <br /> <br />CITY OF ZEPHYRHILLS PERMITT APPLICATION <br /> <br />BUDDING DEPAR~ 5335 8" at, Z8phyrhi.l18, J"L 33542 ! I <br />813-780-0020 FAX: 813-780-0021 /, !" .. ~, ;: <br />DAn: IU:CIlIVIID 7,1 J ~ .1 <br />I <br /> <br />PHQNZ GONTAC~ i'OR PIIJlHITTING <br /> <br />OWNER'S NAME {\ \ Q..f\ ~ ~ \ . . PHONE' I~ - 5LP% - ~'-\6l- ~ <br /> <br />l(03)J ADDRJ:SS 'Free ,Fa...\ \ A.ve~~~: ~~""''6r'f\\ \\"b I FL. <br /> <br />LEGAL DESCRIPTION I ~ S \ ~ ~.,.. ~I.D(S ~I'IBl'!HlI8N ~.;l..Q\..E.. <br />- - 1..1 ~- <br />PARCEL I~ t W:-~V>-Ol.a.-OD \0'" CO.CD - OO~ (OBTAIN FROM PROPERTY TAX NOTTCE) <br /> <br />WORK PROPSED: ~EW CONSTROCTION <br />OSIGN <br /> <br />o ADDITION <br />o MOVE <br /> <br />OALTERATION <br />o DJi:MOLIBH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />PROPOSED USE: OSGL FAMILY DWELLING DMOLTI-YAHILY <br />~COMHERCIAL OINDOSTRIAL <br /> <br />0, or UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE aOME <br />o OTHER <br /> <br />c:J RESTAORANT & HEALTH DEPARTMENT APPROVAL <br /> <br />O.8C!UP'l'ION 01' WORK Nell."") I L -, OLD ~Q.UCt r"l'"'Foo1 ?~ E - Er4\~<:d N"'e-;-cd <br />J \ 1 '~ I to I , \OL..()G, .. <br />BUILDING SIZE . OLP '5F SQUARE rOOTAGE 1\., blt> Sf HEIGHT a - <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />RES IOEN'l'IALI .ATTACH (2) PLOT PIoMS ~ (2) SETS OF B. UILDING PLANS & (1) SET ENERGY FORMS. flu -0-(/ <br />C~CIAL: ATTACH (3) SETS OF BOILDING PLANS & (1) SET ENERGY FORMS. ') _ 1)1) T <br />X!" SIGN PERH~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. 1 ~ ,^ r 0 I <br />PROPERTY SURVEY REQUIRED FOR ALL ,NEW CONSTRUCTION. l.) 1 '1 <br /> <br />()j~l: uNDL <br /> <br />'f ~,~ C-~J~'L_ <br />\. )...--. ':\ <br />W.R.E.C. GI\.) \ r' 1< ~ <br />.")l \..- <br /> <br />)&J~ <br />~~~,o~ <br />~~ <br /> <br />PBRMITS REQUESTED <br /> <br />~BUlLDItlG <br /> <br />$!loo J roo . 00 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />, <br />AMP SERVICE <br /> <br />o Progress En~rgy 0 <br /> <br />o PLUMBING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION elF MECHANCIAL INSTALLATION <br /> <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />o FRAME <br /> <br />~'l'EEL <br /> <br />o OTHER <br /> <br /> <br />FINISHED FLOO~ ELEVATIONS <br /> <br /><?5 . 00 <br /> <br />IS PROJECT IN FLOOD ZONE A <br /> <br />- , - <br />- - <br />~ "1 . . _ _ _ <br />" -------- >. -- <br /> <br />BU:rLDBR <br /> <br /> <br />COMl'ANymtY\Y'<\Lr * ~ll ~i\ \~ J me <br />STATE CERT OR REGIST t CGlc..(Y~,6~'5 <br /> <br />*..*............._~****.~*.**.*.****.~**.*******-*.*..*****......* <br /> <br />IlLl:C1'RICIAN <br />SIGNATOREX <br /> <br />COMPANY <br /> <br />STATE GEaT OR REGIS'!' . <br /> <br />..****....*.*..~~**.*...*..*.*..*..*.*..**.*~****.***********....* <br /> <br />~ COMPANY <br />SIGNATURE~ STATE CERT OR REGIST t <br />/ . <br />...*.*.****.**********w..**********.***..*************.........*.* <br /> <br />MECHAM:ICAI. <br /> <br />SIGNATURE >c <br />/ <br /> <br />COMPANY <br /> <br />STATE CERT OR REGIST . <br /> <br />*.*.*.*.***..*...........**.*.**......*.....~****.....*.**.*r*~.. <br /> <br />0'fl{U <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIBT t <br /> <br />Yv\~r7L h..-DG. Db.>) 6N <br />f{lt) ~1\.. (~ I s.~ -,,~u'~ wf <br /> <br />J")rttl i~TJtl <s 1 J4L L <br />P[Ajv!> T <br /> <br />i));,..' 5,.) ~ Wl \ -r-T~() <br />