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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 />BUILDING DEPARTMENT 5335 aU St, Z...phyrhi11.s, FL 33542 <br />813-780-0020 gAX:813-780-0021 <br /> <br />DATE RlilCE IVED <br /> <br />O~NER' S NAME US tlofW\(.. ~r;fef^~llr-- Le..^^ct1 <br />JOB ADDRESS r;?LI?~rch~;/v//~ G,,~ <br /> <br />PHONE <br /> <br />913 -7(/1 -5:1..77 <br />ey.-I./i43$ <br />'b13~~7~1-5;t-n <br /> <br />PHONE CONTACT FOR PEnMITTING <br /> <br />SUBDIVISION Cte5fvfti-J ,.I,'[/~ <br /> <br />LEGAL DESCRIPTIO~: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL ID * <br /> <br /> <br />~!j'o <br /> <br /> <br />N <br /> <br />WORK PROPSED, <br /> <br />CONSTRUCTION <br /> <br />o ADDITION <br />o MOVE <br /> <br />o ALTERATION <br />D DEMOLISH <br /> <br />D REPAIR <br /> <br />o INSTA1..L <br /> <br />PROPOSED <br /> <br />DS:IGN <br />USE~GL. FAMILY <br />DCOMMERCIAL <br /> <br />DWELLING <br /> <br />DMULTI-FAMILY <br />o IND,USTRIAL <br /> <br />Of OF UNI.TS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />DOTHER <br /> <br />DESCRIPTXON OF WORK <br /> <br />C::J RESTAURANT <br />ew sf((' <br /> <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />ZC77h <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 SrGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />& L(~;)5 <br /> <br />M BUILDING <br />o ELECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ /C/9/z,/O <br />, ~ S:- 0 AMP SERVICE <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />?f <br /> <br />Progress Energy <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAs 0 ROOFING 0 SPECIALTY <br />TYPE OF CONSTRUCTION~BLOCK <br />FINISHED FLOOR ELEVATIONS <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 /> <br />BUILDER <br />SrGNA'~otE <br /> <br />STATE CERT OR REGIST . <br /> <br />SIGNATURE <br /> <br />/~ <br /> <br /> <br />.***.***~*************~*w***.******_*****.**********************k* <br /> <br />****~*********.*******.*.******.*******. <br /> <br />COMPANY J5t~~ ~"'$l.o ~~<: <br />e RoO t '4 SOl , <br /> <br />ELECTRICIAN <br /> <br />STATE CERT OR REGIST . <br /> <br />PLOMBER <br /> <br /> <br />COMPANY 1)" VJ~ Lovl'- pIVM\1.f <br /> <br />STATE CERT OR REGIST # C F"C to{ d-. (.;).Cf <br /> <br />sIGNATURE <br /> <br />SIGNATURE <br /> <br />* ********** ******** ** **** **~*:** * *l"b**** **r.* *.* <br /> <br />~ . COMPANY. f' "1 S Oft. A '- . <br />.' STATE CERT OR REGIST . CA<-os-o Ltc 0 <br /> <br />MECHANICAL <br /> <br />O'l'HER <br /> <br />....*............... <br /> <br />~~"1 <br /> <br />~............~~~;~:..~:;;~i;;;;......... <br />-<;t/. STATE CERT OR REGIST * CC ~CoS7991 <br />/' <br /> <br />SIGNATURE <br />