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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />I!o~ Ca,(~ <br /> <br />'i(~ " <br /> <br />/- ~ CX)r7'7/- ~ 777 <br />34620 5pHbNf:339. <br /> <br />ADDRESS 6290 147TH AV N. <br />MERVIN THOMPSON <br />OWNER <br /> <br />CLEARWATER <br /> <br />5134 19TH ST <br /> <br />JOB LOCATION <br /> <br />LOT SIZE X <br />". <br /> <br />SUBDIVISION fr1 /.t <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL 1. D , ~t l/..Jt::, -;:l\ - Dol '0 - ::; not> 0 --- 1">rJl ~~ <br /> <br />{..h flir\ fU,. .' (S' <br />'JV\f4 ':<1'- <br />WORK PROPOSED:____New Construction ----Addition ----Alteration ~epair ____Install <br /> <br />_Sign/Temp. <br /> <br />_Sign <br /> <br />_Move <br /> <br />~emolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />----l1/ F <br /> <br />_~t of Uni ts <br /> <br />_----l1/H <br /> <br />_Commercial <br /> <br />---:.,..Indust, <br /> <br />~Swim. Pool <br /> <br />Other <br /> <br />~estaurant & Health Department Approval <br /> <br />BUILDING $IZE: <br /> <br />X <br /> <br />. Square Feet, <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 />$1675.00 <br /> <br />_BUILDING <br /> <br />$ <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 />----l1ECHANICAL <br /> <br />$ <br /> <br />valuation of Mechanical Installation <br /> <br />_PLUMBUfG <br /> <br />.. '. <br />. . <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY. . <br /> <br />TYPE OF CONSTRUCTION: _Block _Frame _Steel <br /> <br />Other <br /> <br />... ':~ <br />'","; <br /> <br />FINISHED FtOOR ElEVATIONS: <br /> <br />FT, <br /> <br />,- ';":: . ;~., :.' .~y ~':' ,f. ,". <br /> <br />,,", , <br /> <br />****************************************** <br />CONTRACTOR SD~ARE IND. INC. <br />Company CRC 041914 <br />State Cert, or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />JOHN RICH <br />BUILDER <br /> <br />Signature <br /> <br />l <br />ET.F.CTRICT AN ' <br /> <br />, <br />Sismature <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 />PLlJMRER <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 />OTHER <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br /> <br />... <br />