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<br />MAR/31/2005/THU 11:40 AM <br /> <br />owNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />ZEPHYRHILLS BUILDING <br /> <br />FAX No. 813-780-0021 <br /> <br />P.002 <br /> <br />CITY OF ZEPBYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 aU St, ZOitphyrhi11.a, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />DATE Rli:CE IVED <br /> <br />1)5 tlolV\t. G,tftf^~llr-, - Le..^^~ ' <br />7 ~31 , //?r'r'ch~rY///'G <br /> <br />fJiJ - 7~9 - 5:J.77 <br />ey..+./t,3$ <br />?!13 -~ 7(/i - SJ.. 71 <br /> <br />PHONE CONTACT FOR PEllMITTING <br /> <br />PHONE <br /> <br />BLOCK <br /> <br />Cre5fvftw IJ;(/$ <br /> <br />PARCEL ID it <br /> <br />LEGAL DESCRIPTIO~: LOT(S) <br /> <br />M <br /> <br />WORK PROPSEO: <br /> <br />PROPOSED <br /> <br />SUBDIVISION <br /> <br /> <br />o~ <br /> <br />RT <br /> <br />N <br /> <br />-- ~/-..>S.SJ; OO~ <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o ADDITION <br /> <br />o ALTERAT ION <br />o DEMOLISlI <br /> <br />CONSTRUCTION <br /> <br />DsrGN <br />USE~GL, FAM1LY <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />DMULTI-FAMILY <br />o IND,USTRIAL <br /> <br />D. OF UNITS <br />o SWIMMING POOL <br /> <br />o HOBrLE HOME <br />o OTHER <br /> <br />DWELLING <br /> <br />r:=J <br />New <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />'A/1Qc/e/: CJ.r4.rz-l: 2Oo~ <br />/020 <br />SQUARE FOOTAGE , // ---'--- <br /> <br />sf {( , <br />) <br /> <br />BUILDING SIZE <br /> <br />OESCRIPT:IoN OF WORK <br /> <br />HEXGHT <br /> <br />RESIDENTIAL:, ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY ~ORMS. <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 />~ BUILDING <br />o ELECTRICAL <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />PERMITS REQUESTED <br /> <br />$//t?~ Y/O <br />./'S:-O <br />, <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W' <br /> <br />o <br /> <br />AMP SERVICE <br /> <br />W.R.E.C. <br /> <br />Progress Energy <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br />TYP~ OF CONSTRUCTION~BLOCK <br />FINISHED ~LooR ELEVATIONS <br /> <br /> <br />'BUILDER ' <br />SJ:GNA;O~ <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />PL~ER <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />o OTHER <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 . CI3C /Z.S/~4l- <br /> <br />COMPANY <br /> <br />D~~ <br /> <br />P~~lo <br /> <br />~~c <br />eRoo, '4 SOl , <br /> <br />STATE CERT OR REGIST i <br /> <br />COMPANY l)... vl.{ La II J<- pI" M ~ l,., ~ <br />STATE CERT OR REGIST ~ CF'C lfd {,,;}"i <br /> <br />............. .... ...... .... * .. .... .. .. .... *~......... .... ..~.., -,..;,"''' "".. .., '*(. '* ".* <br />COMPANY, f' "1 '::> Oft. A <... ' <br />STATE CERT OR REGIST . CA-<:-- oS"o tf( (:) <br /> <br />~R f-~~" ...~........ ...~~~:::..c: sf:;i,:; ~... ...... <br /> <br />SIGNATURE ~ U-- STATE CERT OR REGIST It C C - Co S 7 9 9 I <br />