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<br />OWNER'S NAME <br /> <br />cIrry OF l6~.t'n~~n..L.u.u.... .........---- ------ <br />BUI~ING DEPARTMENT 5335 8~H st, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 , \)""2-. U. o/,J) <br />DATE RECEIVED I <br /> <br />PHONE GONTACT FOR PERMITTING f)I'J', 111-. DV~S <br />\\ c+'CY~ <br /> <br />\Vr~ ~ (.10 UO(L.w~ ...J PHONE ql.fDJ. ~ 7. 7roo~"L <br /> <br />JOB ADDRESS 1-"S ~:t \.,)'^'^-" ~v'.o. <br /> <br />*"l+~WlJl-J J fL-: 11 ~ '1, I <br /> <br />SUBDIVISION ~~ <br /> <br />LEGAL DESCRIPTION: LOT(S) OoS D BLOCK 00700 <br />PARCEL ID it ~-1S'':' 1-\ - ocoo- ooJoo - ,00$00 <br /> <br />(OBTAIN FROM PROPERTY,TAX NOTICE\ <br /> <br />WORK PROPSED: ONEW CONSTRUCTION <br />~SIGN <br />PROPOSED USE: DSGL FAMILY DWELLING <br /> <br />l/JCOMMERCIAL <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />[] INSTALL <br /> <br />DMOVE <br /> <br />D DEMOLISH <br /> <br />OMULTI -FAMILY <br />o INDUSTRIAL <br /> <br />[]ft OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HO~ <br />o OTHER <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J RESTAURANT & HEALTH DEPARTMENT APrROVAL <br />t.-F""av~ 01.,-0 $l\).N/f~P IrtJO I~.s~ ~ ~1\)\Nft~ <br /> <br />BUILDING SIZE <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 PERM~T ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />SQUARE FOOTAGE <br /> <br />HEIGHT <br /> <br />I~Oe.- ~IPr <br />CP'n'rc Cet.\- - <br /> <br />-1d-o.o1> <br /> <br />PERMITS REQUESTED <br /> <br />'l.-i 0<<' <br /> <br />0" <br />--- <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />[] BUILDING <br /> <br />$ <br /> <br />D ELECTRICAL <br />o PLUMBING <br />o MECHA~ICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF'MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />D SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />[] FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br />IS PROJECT IN FLOOD ZONE AREA[] YES 0 NO <br /> <br />[--~-~:= ~ ~ ~~~_=~ c :__:__!:~~~~~:- ~] - =,____~~ .. - . ~,-;-.c <br /> <br />BUILDER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST i <br /> <br />****************************************************************** <br /> <br />SIGNATURE <br /> <br /> <br />....-- <br />/} ~ v <br />0" <br /> <br />COMPANY ~(El;~ e....- <br />STATE CERT OR REGIST .' ~ I~OO) 1'iS" <br /> <br />ELECTRICIAN <br /> <br />************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST i <br /> <br />****************************************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST i <br /> <br />***********************************~*~******~****~*************** <br /> <br />OTHER <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST i <br />