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<br />I I <br /> <br />cJtj ~((,!tJ! <br /> <br /> <br />DATE RECEIVED I /; t /05 <br />,. <br /> <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />OWNER'S NAME <br /> <br />\\I\\c.~ IUt.;,o':) <br />G, \ \ , \ ~ ~ ')-r- <br /> <br />PHONE CONTACT FOR PERMITTING , <br />f0 > -- S I 2-- ~ 4f"6 c;;- <br />PHONE 78,-~ (04'2... <br />z ~p H 'i f2-l+t l,c\ h- 535"""4 L- <br /> <br />JOB ADDRESS <br /> <br />, <br />LEGAL DESCRIPTION: LOT(S)~ <br /> <br />! <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />WORK PROPSED: 0 NEW CONSTRUC ION <br />I <br />, <br /> <br />o ADDITION <br /> <br />o ALTERAT ION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />oSIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />PROPOSED USE: DSGL FAMILY D~ELLING <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS 0 MOBILE HOME <br />~ fH?:,o\JE &i2-ov Ni) <br />~SWIMMING POOL o OTHER <br /> <br />c=J R$STAURANT & HEALTH DEPARTMENT APPROVAL <br />I <br />J tJ ~ rp+u... f.hB (} -..J ~ 6- 'R.fJ v IV J!J <br />I <br />~ <br /> <br />RESIDENTIAL: ATTACH (2) PLOT~PLANS & (2) SETS .OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />IF SIGN PERMIT ONLY (2) SET OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />SWI MM,,Jt.r <br /> <br />fOOL- <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />PERMITS REQUESTED <br /> <br />N, f2Si(} ~Ji.. i7t;r; I / <br />fCV~ jV\. (~Itr>r("" frY~ V <br />r\~~ T~ pJVL~'\IT, <br /> <br />VALUATION OF TOTAL CONSTRUCTION I <) )~ ~ \.fL <br /> <br />o BUILDING <br /> <br />$ <br /> <br />o ELECTRICAL <br /> <br />~ AMP SERVICE <br />I <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALT <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK, <br />I <br />FINISHED FLOOR ELEVATIONS --i <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />o NO <br /> <br /> <br />BUILDER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />**************** ************************************************* <br /> <br />SIGNATURE <br /> <br />~~~ <br /> <br />COMPANY ~'5. .., .~ <br /> <br />ELECTRICIAN <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />****************************************************************** <br /> <br />MECHANICAL COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br /> <br />**************** ************************************************ <br /> <br />OTHER COMPANY <br /> <br />SIGNATURE STATE CERT OR REGIST # <br />