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<br />APPLICATION FOR PERMIT <br />CITY OF .ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />" <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />OWNER <br /> <br />JOB LOCATION <br /> <br />LOT SIZE_X <br /> <br />AREA SQ.FT, <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D, 4t <br /> <br />WORK PROPOSED:_New Construction ~ddition ~lteration _Repair ~Install <br /> _Sign/Temp, _Sign _~ove --:-Demolish <br />PROPOSED USE: _Single Family ---11/ F _4t of Uni ts _M/H <br /> _Commercial _Indust, _Swim. Pool Other <br /> <br />----Restaurant & Health Depar.tment Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />. <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,u <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.** <br />**COPY OF CONTRACT REQUIRED, <br /> <br />PKRMITS REot~STED <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 />-HECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />RU{,C:...NI.> <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 /> <br />Electrician <br /> <br />Company <br /> <br />Signature City License Registration 1F <br />***************************************************************************************** <br /> <br />Plumber <br /> <br />Comp.:ny <br /> <br />Signature C:P.ty Li(:ense Registration 1F <br />***************************************************************************************** <br /> <br />~. <br /> <br />Mechanical <br /> <br />Company <br /> <br />Signature I ::ity License Registration # <br />********************..~.*******.*~*~***.*********~**.*.*****************~**************** <br /> <br />Other <br /> <br />Company <br /> <br />Signature <br /> <br />City License Registration # - <br /> <br />I Hereby <br />true d <br />comp <br />giv <br />re <br /> <br /> <br />certify, that I have read and examined this application and know the same to be <br />rrect, Ail provisions of law and o~dinances governing this type of work will be <br />with w her specified herein or not, the granting of a permit does not presume to <br />thor y t iolate ur CG.nce,;. the provisions of any other state or local law <br />ting onst bon or p<<1orm"ace of constructi~JVvJ. _ /-' <br /> <br />~ k '----- CY~l (VJA ~ _._. <br />S}&nhture of Owner <br /> <br />~/ou...1 Cl/ Date <br /> <br />.. f _ <br />--signed by the owner and notarized. <br /> <br />Contl'actor <br /> <br />Signa e <br /> <br />.~ -?G "c,! Date <br /> <br />,~~l~^!;~,~'~~>r;~, fIf,rrc. ')~ rv:mmA:' . <br /> <br />t1UJ'li!;.L:D -:-tj'J'('~)~,j"')T "P,IRE~, MA.Y;l 7~ : ?f!!~=-. <br /> <br /> <br />Cf~ ~"0fKrIU <br /> <br />NOTARY PUBUC. STATE OF J:'Lb~Il)l(, ,.. <br />MY COMMISSION EXPIRES: MA'I'- 17. !'}!);" .- <br /> <br />.ON~~~ <br />