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<br />APPLkCATkON FOR PERMkT <br />CITY OFZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />. APPLICANT .:J3 ; I / V t<. ~y <br />3':'- .... /'lIr .. ,t,,(. <br />ADDRESS 0 6 L ...AA V } 5>' 'f- / A- ...v' <br /> <br />,:;U~ J5,q~)L <br /> <br />JOB LOCATION I);;' 0 / ~');{ CJ-j-,.2, If' LOT SIZE <br /> <br />LEGAL DESCRIPTION' LOT (S) ~ BLOCK \"- SUBDIVISION 2 '" ~y ~ i I ~ &b'r- 'ft"n""j>A.v~ <br /> <br />PARCEL I.D.~~ 01- a.b - ':J..{-'b'" ~I')6)O- 4-00- C>~";L} <br />, <br /> <br />Pd. 1).c. <br /> <br />Fl. <br /> <br />PHONE <br /> <br />"e!)2J-CJ66_') - :. <br /> <br />'.,' " <br /> <br />OWNER <br /> <br />x <br /> <br />AREA SQ. FT. <br /> <br />WORK PROPOSED:____New Construction '~ddition ~lteration _Repair ____Install <br /> I:. ~ .' <br /> ____Sign/Temp. _Sign _Nove A-DemoliSh <br />PROPOSED USE: ____Single Family '.~M/F --'-~~ of Units __H/H <br /> _Commercial ~Indust. _Swim. Pool Other <br /> _Restaurant & Health Department Approval <br /> .?O xei. '>;0 (0 r-- <br />BUILDING SIZE: Square Feet, Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />COM.l'1ERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.H <br />**COPY OF CONTRACT REQUIRED. ' <br /> <br />,PBRMTTS REQtmSTED <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 />H.R.B.C. <br /> <br />____MECHANICAL <br /> <br />$ <br /> <br />Va~uation of Mechanical Installation <br /> <br />.... <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />____PLUMBIN"G <br /> <br />TYPE OF CONSTRUCTION: ____Block ____Frame _Steel <br /> <br />_Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />Signature <br /> <br />~ONTRACTOR SECTION <br />Company <br />, State Cert. or Regist. n <br />City License Registration ~~ <br />****************************************** <br /> <br />nUTT.DER <br /> <br />Si!:'nature <br /> <br />Company <br />State Cert. or Regist. U <br />City License Registration 0 <br />****************************************** <br /> <br />ELECTRTCTAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or.Regist. ~ <br />City License Registration 0 <br />*******************************~********** <br /> <br />p'LUMBF.R <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />.City License Registration 0 <br />*************************K***************6 <br /> <br />HECHAN1CAL <br /> <br /> <br />Company <br />State Cert. or Rcgist. 0_ <br />City License Registration <br /> <br />If [))(:> '/ J.../'7 I / /17 <br />" <br />1r <br /> <br />Signature <br /> <br />**********************************f******* <br /> <br />PERl-lIT OFFICER. <br /> <br />APPLICATION APPROVED BY. <br /> <br />" <br />