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<br />~~2/31/2005/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 ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 erR St, ZQphyrhi11.s, FL 33542 <br />813-780-0020 VAX: 813-780-0021 <br /> <br />DATE Rli:CEIVED <br /> <br />us ~~ Co\rDf"\~Or-- - <br />7~/Lf ~,.ch~t///k <br /> <br />g/3 -7(/1 -5:1.77 <br />e'fJ../i63$ <br />?J13~7~1' -5:.t.71 <br /> <br />PHONE CONTACT FOR PERMITTING <br /> <br />Le..f\AoU <br />C:r-- <br /> <br />PHONE <br /> <br />BLOCK <br /> <br />Cr-e5fvrt\-J Mill$ <br /> <br />PARCEL ID '* <br /> <br />LEGAL DESCRIPTIO~: LOT(S) <br /> <br />N <br /> <br />WORK PROPSED; <br /> <br />PROPOSED <br /> <br />SUBDIVISION <br /> <br /> <br /> <br />o REPAIR <br /> <br />CONSTRUCTION <br /> <br />o ALTERATION <br />o DEMOLISH <br /> <br />o INSTALL <br /> <br />DSIGN <br />USE~GL~ FAMILY <br />o COMMERCIAL <br /> <br />o MOVE <br /> <br />DMULTI - FAMIL Y <br />o I No.USTRIAL <br /> <br />Of OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />DOTHER <br /> <br />DWELLING <br /> <br />c=J RESTAURANT &. HEALTH DEPARTMENT AP~VAL <br /> <br />/Jew sf{( j A/lQc/e/: Oy;4r~ ZOCY 3; <br />SQUARE FOOTAGE /920 HEIGHT <br /> <br />BUILDING SIZE <br /> <br />DESCRIPTION OF WORK <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 />PERMITS REQUESTED <br /> <br />$ /??~/ cP/O <br />, /CO r::;;- 0 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />~. <br /> <br />o <br /> <br />AMP SJ!:RVICE <br /> <br />Progress Energy <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br />o OTHER <br /> <br />Lf~ (IV <br /> <br />o G~AS 0 ROOFING 0 SPECIALTY <br />TYP~ OF CONSTRUCTION~BLOCK <br />FINISHED FLOOR ELEVATIONS <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />D OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES ~O <br /> <br /> <br />*..***** ******** ****** *****w*******.**********..*******.*.**~ <br /> <br />4# COMPANy_P~-i P"110 ~<: <br />.::..* **~*-:..**....** ,,*...... * * *:~:~:*~::~*~:*:::~::*:***~*~~:~ ~ SOl' <br />~;: COMPANY l)" \I)~ Lool1" P/JM\.I., f <br /> <br />STATE CERT OR REGIST ~ CF'C If d la-ct <br /> <br />.::.. .~~* ,,**.. H" ** H" **.. **.. **.. ~~;;;~~f~~:; *S~O~H Ar ~.... <br />~~ . STATE CERT OR REGIST it CA<--C>5'O Ltc (:) <br />./ <br />::':TUR~~'~"~~" .... ..... '::::~:~~~!::~~~~' ~~'-' ~.~s 7 9 ~ I <br /> <br />BUILDER <br />SIGNA;otE <br /> <br />ELECTRICX.AN <br /> <br />SIGNATURE <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST t <br />