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<br /> <br />~) <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br /> <br />" . <br /> <br />1-" 'l (;1.J- 77/ - ~ -)'77 . <br /> <br />APPLICANT <br /> <br /># /k.<.. C"-4/Ct-. <br /> <br />:,:~~". <br /> <br />ADDRESS 6 290 147TH AV N. <br />VERNON TAYLOR <br /> <br />CLEARWATER <br /> <br />34620 PHONE 53'9-0:nQ <br /> <br />OWNER <br /> <br />5220 17TH ST <br /> <br />1 76 <br /> <br />'. <br /> <br />AREA SQ. FT. <br />A4!/S~ - <br /> <br />JOB LOCATION <br /> <br />LOT SIZE <br /> <br />x <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL. I.D.tl.ll-J h ,-)1 -(0) D - J b I ~C> - Of] l:> <br /> <br />SUBDIVISION <br /> <br />~ ,e-'-e'"\ 'j n Pc t'ch <br />WORK PROPOSED:____New Construction ----Addition ~lteration ----Repair ____Install <br /> <br />_Sign/Temp, <br /> <br />____Sign _Move <br /> <br />~emolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />---->t/F .-~tl of Uni ts <br /> <br />_~/H <br /> <br />____Commercial <br /> <br />---.:...tndust, ~Swim, Pool <br /> <br />Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />. Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <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 FORMS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PF.RMITS REOUESTED <br /> <br />$2000.00 <br /> <br />'Valtiation.of.Total Construction <br /> <br />____BUILDING <br /> <br />$ <br /> <br />;., J " <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />,r-Florida Power Corp. <br /> <br />_W.R.E,C. <br /> <br />:~~~~~i,~ ~ <br /> <br />~ECHANICAL <br />____PLUMBUlG <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />.... <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block ____Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT, <br /> <br /> <br />Signature <br /> <br />****************************************** <br />CONTRACTOR SECTION <br />Company HOMRCARF. TNn TN(' <br />State Cert. or Regist. 4~ C'RC' 0.11914 <br />City License Registration # <br />****************************************** <br /> <br />BUILDER JOHN RICH <br /> <br />f <br />ELF.CTRTClAN l <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 />