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<br />. . APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />ib tfli. e41lP- <br /> <br />/ <br />, ~'~, it <br /> <br />';~:". <br /> <br />/- iuO-77 /-37'7/ <br /> <br />....... <br /> <br />ADDRESS 6290 147TH AV N. <br />ROBERT HAMMOND <br /> <br />CLEARWATER <br /> <br />3 4620 PHONE I) J q - 0 11 q <br /> <br />OWNER <br /> <br />4928 19TH ST <br /> <br />312 <br /> <br />JOB LOCATION <br /> <br />LOT SIZE X AREA SQ,FT, <br /> <br />" <br /> <br />SUBDIVISION tltbl,,{-R 5 ArI/ <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br /> <br />PARCEL. i.n:t~- 'If -'lb -;1{ - 00/0 .-0,)(00- (')(/0 <br />. . 12~.;1) Scc-€-e-..... r1..e I:'~ 0 ~ IE ~+- 5'1/4-6 <br />WORK PROPOSEDl____New Construction ~ddition ----Alteration ~epair ____Install <br /> <br />__Sign/Temp, <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />---11/F <br /> <br />____t~ of Units <br /> <br />._M/H <br /> <br />____Commercial <br /> <br />____Indus t , <br /> <br />~Swim, Pool <br /> <br />Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />. Square Fee t, <br /> <br />Height <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 />**COPY OF CONTRACT REQUIRED, <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br /> <br />~49fi5_00 <br />$ .3. ij b-..5-: CTb <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 />---11ECHANICAL <br />_PLUMBIN"G' <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />.... <br /> <br />GAS <br /> <br />. ROO"ING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: : ____Block ____Frame ____Steel <br />FINISHED rFLOOR EU~VATIONS l FT, . <br /> <br />Other <br /> <br />Signature <br /> <br />****************************************** <br />CONTRACTOR SECTION <br />Company IH1MRrA RR TNn TN(' <br />State Cert, or Regist. tF C~C~19~~ <br />City License Registration t~. -3 <br />****************************************** <br /> <br />-) <br />~JA..e4, <br /> <br />BUTT,DER JOHN RICH <br /> <br />f <br />ET.F.CTRICIAN ' <br /> <br />'; t <br />.' i <br /> <br />Si2Ilature <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # _ <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHF.R <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER, <br /> <br />" <br /> <br />_...~-~-_. <br />.' <br />