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<br />CITY OF ZEPHYRHILLS PERMIT APPLICAT~ON <br />BUILDING DEPARTMENT 5335 8TH St, Zephyrhills, FL 33542 <br />813-780-0020 FAX: 813-780-0021 <br /> <br />PHONE CONTACT FOR <br /> <br />DATE RECEIVED <br />PERMITTING ~IS"- '1l{ - 2fS9 <br />V<1~ L\ vb!- <br />PHONE gl3-gg2- J-fb63jl33) <br /> <br />. . <br /> <br />I..Ln (lev- 'l-btYL~, LM6 <br />JOB ADDRESS r""f5 ~ lJ M+. La l.,L (e I ~il v-e,. <br />LEGAL DESCRIPTION: LOT (S) ~4 BLOCK--&- <br />PARCEL 10 # 3)'"- d-~- 2l-0 \ZO- Qr:01):. 114D <br /> <br />OWNERtS NAME <br /> <br />SUBDIVISION 6l..t.l-l-viuAJ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPSED: ~ NEW CONSTRUCTION <br /> <br />o ADDITION <br /> <br />OALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />o SIGN <br /> <br />o MOVE <br /> <br />o DEMOLISH <br /> <br />o COMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />DSWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />PROPOSED USE: I}jSGL FAMILY DWELLING <br /> <br />DESCRIPTION OF WORK <br /> <br />c:J <br />UlA) SU <br /> <br />RESTAURANT & HEALTH DEPARTMENT APPROVAL <br /> <br />U{bj(/~, W/)-trf-1t- <br /> <br />SQUARE FO TAGE ;}311 <br /> <br />HEIGHT <br /> <br />15 ' <br /> <br />. <br /> <br />BUILDING SIZE <br /> <br />o BUILDING <br /> <br />$-1 tYl3 Jt)~./ <br /> <br />VALUATION OF TOTAL <br /> <br />& (1) SET ENERGY FORMS. <br />FORMS. <br /> <br />(~elL s.-(~.... - <br /> <br />\~o Cu"st . .leeS f!o ~ <9['>( <br /><.::-Ic _WlW,...:oL~ ..LZ1l-- <br />~cL- <br />c '\"'~J. S,o-I" eN, ()~~_..,€) <br />CONSTRUCTION (. ';lQ:IyvvJ i7lw <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY <br />IF SIGN PERMIT ONLY (2) SETS OF ENGINEERED PLANS REQUIRED. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />o ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o Progress Energy 0 <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />1i,QCD,- <br /> <br />. <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o SPECIALTY <br /> <br />o OTHER <br /> <br />TYPE OF CONSTRUCTION: ~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 <br /> <br />COMPANY <br /> <br />SIGNATURE <br /> <br />STATE CERT OR REGIST # <br /> <br />SIGNATURE <br /> <br />*'* *** ** * * * * ** ***** * * * ** * ** * ***** ***** **** ****'***..** W. <br /> <br />&i ~. A\ <br />COMPANY /Y1 -,u ';}) <br />STATE CERT OR REGIST #, O€J /3/ ~ f- fyl.Y <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />************************************************** <br /> <br /> <br />COMPANY ~ >leaf * <br />STATE CERT OR REGIST # CF~'fd 99? <br /> <br />PLUMBER <br /> <br />SIGNATURE <br /> <br />HHHHHH~~~;:~~':lF.HL~;t;#~'ir,jk. 49 <br /> <br />STATE CERT OR REGIST # cACLJso 4/0 <br /> <br />MECHANICAL <br /> <br />'1THER <br /> <br />*1**************************************************** <br /> <br />/l &m'J. . ~.,~ <br />COMPANY L---. U->n. ' L <br />W STATE CERT OR R;~'~;,r# f6 <br /> <br />c c.c C5'7cr4/ (' ? <br />,:-B a., - G'1 L; - .15:s-'1 C <br /> <br />~ 'TURE <br />