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<br />r <br /> <br />APPLICATION FOR PERMIT <br />CITY OFZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER <br /> <br />7n/J. 7) fJ-rVJer VeerV' <br />6- ;;l. 3 ~ /b. r)... ~ <br />, <br /> <br />/n1. UfitVder ueery- <br />JOB LOCATION 0-;;' 3 fl / t" [J:..- J-r. <br /> <br />PHONE <br /> <br />APPLICANT <br /> <br />ADDRESS <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. ~~ <br /> <br />J J - d- I., " ;;2 j - 00/ 0 -' ) 7 q 0 0 - '7 () - <br /> <br />OJ~o <br /> <br />WORK PROPOSED:____New Construction ____Addition ----Alteration ____Repair ____Install <br /> <br />____Sign/Temp. <br /> <br />_Sign <br /> <br />_l'love <br /> <br />____Demolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />____M/F <br /> <br />____~~ of Uni ts <br /> <br />.____1'1/ II <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 <br /> <br />Square Fee t, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COl'fr1ERCIAL : <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'lS. ,~* <br />**COPY OF CONTRACT REQUIRED, <br /> <br />PERMITS REQUESTED <br /> <br />____BUILDING <br /> <br />Valuation of Total Construction <br /> <br />L-- ELECTRICAL <br /> <br />AMP Service ~ Florida PO\,er Corp. <br /> <br />_H.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLlH-lBHfG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIA1.TY <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. 0 <br />City License Registration ~t <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />/) ~/" c.1 r > ~ .~~' <br />ET.ECTRTCT AN t" ~/.:247~ ~:/.?../'...r p~ Company ~1i <br />;;~ y;J~~/ --Jl/ State Cert. or Reist. iF E.R,. DO 11039 <br />Si!!nature /./?..-7. ~ /,_ ~~ City License Registration il -P:- /? ~ <br />.,~. *f,* :k, * f,* * ****** ******* ,~* * * *,~ *,~ 1:" -!:,~"" 1: 1: 1:" <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. 0 <br />City License Registration # <br />****************************************~* <br /> <br />I'1ECHANTCAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration 0 <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />**~*************************************** <br />'// d4U',{~ .x-'o/ --<'_^ ~ , <br /> <br />PERI-lIT OFFICER. <br />