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<br />DEC/05/2005/MON 04 23 PM ZEPHYRHILLS BUILDING FAX No. 813-780-0021 POOl/DOl <br />CITY OF ZEPHYRHILLS PERMIT APPLICATION <br />BUILDING DEPARTMENT 5335 S'K st, Zaphyrhills, FL 33542 <br />813-780-0020 ~AX'B13-7BO-0021 <br /> <br />DATE RECEIVllD <br /> <br />PHONE CONTACT FOR PERWITTING <br /> <br />yo/-'-H,9 43~C- <br /> <br />0.."" ,AM< fwn H CVJ 11A.- <br />JOB ADDRESS <..0.1 'lCJ . 5S I ~ ~1 ~lJ ) <br />LEGAL DESCRIPTION: LOT (S) 'lg BLOCK <br /> <br />PARCEL ID * <br />WORK PROPSED: ;(NEW CONSTRUCTION <br />DSIGN <br />PROPOSED USE: OSGL FAMILY DWJ;:LLING <br />DCOMMERCIAL <br /> <br />(OBTAIN FROM PROPERTYT~ NOTICEI <br /> <br />o ADDITION <br />o MOVE <br /> <br />DALTEAATION <br />o DEMOLISH <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />DMULTI~FAMILY <br />o INDUSTRIAL <br /> <br />0* OF UNITS <br />o SWIMMING POOL <br /> <br />~lOBILE HOME <br />o OTHER <br /> <br />BUILDING SIZE <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />I y)( 3LP p~J( rnec-LU'_ <br />sQUARE FOOTAGE ""F)()l--I <br /> <br />HEIGHT <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 />PERMITS ~QUESTED <br /> <br />o BUILOIim <br />o EI..ECTRICAL <br />o PLUMBING <br />o MECHANICAL <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTROCTION <br /> <br />- AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W. R.~;.C. <br /> <br />$ <br /> <br />VALUATION 6F MECHANCIAL INSTALLATION <br />o OTHE'R <br /> <br />o GAS 0 ROOFING 0 SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES 0 NO <br /> <br /> <br />BUILDER Wtll (O-m , . '? ~OMPANY <br /> <br />SIGNATURE ~0k~'~~~E CERT OR REGIST jI 1M CX)OO~S'l{ <br /> <br />*********~~.**.*w.*~***..*w****...*.*w***~********..*******...~**. <br /> <br />w~ lUlK2mfYJ <br />" \; o.1m.J-I1 Jtp /&11 <br /> <br />COMPANY f/)~'J) ?_C OcL/l)(1U--1 <br />STATE CERT OR RF<GIST it f ( COn ,:)~ ~ <br /> <br />EUlCTRICIAN <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br /> <br />STATE CERT OR REGIST t <br /> <br />************** * <br />H!:CHANI~ \V II ) teU)/) <br />SIGNATUR ~Q~ <br />1 <br />*.**.*.~*..**.************~***~*************.*.~***************** <br /> <br />'*"*"'*'**'~f,***'**********'***'** <br />COMPANY . U11 I){ fUW <br />STATE CERT OR REGIST jt CO C C07d.~ <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST t <br />