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<br />APPLICATION FOR PERMIT <br />CITY OF ,ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />"', <br /> <br />APPLICANT ---F".. 'hh It..oA>JU..~~L Ce~ )-~a-~S <br />ADDRESS 59023 ~~ ,~\ <br />OWNER AJ12~ ~ rn V- A,)l)~A-~ ~~~c..~ <br />JOB LOCATION ~~~ ~~ ~\ <br />, <br />LEGAL DESCRIPTION: LOT(S) 3, L/, ~ ~ b BLOCK 1)' <br />PARCEL I.D.1~ II 'Z.c. "2.1 DO\D t>O~OO 003.0 <br /> <br />PHONE <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br />Co (OAJ( <br /> <br />SUBDIVISION <br /> <br />ZH- <br /> <br />,t18 , <br /> <br />~s4 <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ~Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />_Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____1# of Units <br /> <br />____M/H <br /> <br />____Commercial <br /> <br />____Indust. <br /> <br />____Swim. Pool <br /> <br />Other <br /> <br />----Restaurant &: Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feett <br /> <br />Height <br /> <br />RESIDENTIAL: <br />CmlMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORHS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PRRKITS REOUESTED <br /> <br />'. <br /> <br />____BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ JqlnLJ,OD <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />CONTRACTORS <br />Builder <br /> <br />Company <br /> <br />Signature City License Registration # <br />***************************************************************************************** <br />~ ~ Company <br /> <br /> <br />Signature City License Registration # <br />************************************ *************************************************** <br />Plumber Company <br /> <br />Signature City License Registration # <br />********************,******************************~****************~****************** <br />Hochao!cal &12 ~ Company -rM~n/I~ A.c)~~ <br /> <br />Signatur~l~ ~ . City License Registration # <br />......................~.......... ..~.................................................... <br />Other Company <br /> <br />Signature <br /> <br />City License Registration # <br /> <br />I Hereby certify that I have read and examined this application and know the same to be <br />true and correct. All provisions of law and ordinances governing this type of work will be <br />complied with whether specified herein or not,' the granting of a permit does not presume to <br />give aut 0 ty to viol ,or cel the provisions of any other state or local law <br />re ng co t perfo ma e of construction. <br /> <br /> <br />/o/.I~ <br /> <br />;:~~ ~~-<1' <br />Signhture of 0 ler <br /> <br />, <br /> <br />. ~ <br /> <br />S-tO-q, <br /> <br />Date <br /> <br />$-/D -? / Date <br />-'s{gn~d by the owner a~d notarized. <br />