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<br />APPLICATION FOR PERMIT <br />CITY OFZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT ...........t.J4&"S )t1oA'13t- <br /> <br />5""9/(1 t) )C_s/J;; -U A/~ <br />J~HfS Tv\oA6L <br /> <br />JOB LOCATION f:6)() 1<=1+11 S <br /> <br />PHONE <br /> <br />7ft) - S h / 7 <br />/ <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />LEGAL DESCRIPTION: LOT(S) .".1 :~ <br /> <br />BLOCK <br /> <br />LOT sIZE..:SiLX Ic)\] J\REA SQ. FT. <br />SUBDIVISION C ~H <br /> <br />loOl>\) <br /> <br />PARCEL I. D. ~F II -q (Q - "-~ I - 00 /0 - / (,) .~-=') L) - 013 D <br />WORK PROPOSED: ~ New Construction ____Addition ----Alteration ____Repair ____Install <br /> <br />____sign/Temp. <br /> <br />____Sign <br /> <br />_Hove <br /> <br />_Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />_M/F <br /> <br />____~~ of Uni ts <br /> <br />_____1'1/ 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 X /() , <br /> <br />~o Square Feet, <br /> <br />ct <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COM1'1ERCIAL : <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 FORl-IS. ** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMTTS REQUESTED <br /> <br />____BUILDING <br />tv/A ELECTRICAL <br />1liLMECHANICAL <br />JLPLlJHBIN"G <br /> <br />$ <br /> <br />ciou <br /> <br />Valuation.of Total Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_H.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIAl.TY <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. IF <br />City License Registration ~J <br />****************************************** <br /> <br />BUILDER <br /> <br />Si!!nature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration 0 <br />****************************************** <br /> <br />E1.ECTRICIAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. ~! <br />City License Registration 1 <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. I! <br />City License Registration 0 <br />******************~*********************** <br /> <br />l-IECHANICAL <br /> <br />OTHER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration a <br /> <br />APPLICATION APPROVED BY <br /> <br />*********************************~**~***** <br />'-;1/ a AlA"AJ -<f //1 A\" cr <br /> <br />PERl-lIT OFFICER. <br />