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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />ADDRESS <br /> <br />\(\.~- ~" ~\0...C- '- ~ K <br />~ t..\ \...\ \- \ 2- ~ ~_ <br />D <br />JOB LOCATION ~........~- 0 :::,-- <br /> <br />PHONE '),~ .1~0 '-I LlO <br /> <br />APPLICANT <br /> <br />OWNER <br /> <br />"\'-r. "l,k.4. ~'Z.. A. r<.. <br />.a <br />f? <br /> <br />r '--:-- <br />2)' I , <br /> <br />LOT SIZE X AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. tF <br /> <br />WORK PROPOSED:____New Construction _Addition _Alteration ____Repair _Install <br /> ____Sign/Temp. _Sign _~love _Demolish <br />PROPOSED USE: _Single Family _M/F _# of Units ._M/H <br /> _Commercial _Indust. _Swim. Pool 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 />COMl-IERCIAL : <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 FOR~lS. ** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br />~ELECTRICAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />~o U AMP Service <br /> <br />~ Florida Pmver Corp. <br /> <br />_\-l.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLlJMBHtG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <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. # <br />City License Registration 4~ <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />ELECTRICIAN ~. ~~~~,~\....~ Company 7-r \.\ \\....L,\ ~~c..'X _ ~ ~IQ..U\ c.2 <br />~ ~ ~~ State Cert. or Regist. il C)c.JO?-\Co&:- <br />Si!!nature-..........~~ \-..-/L-) City License Registration il It\ <br />fe* **** ******** ****** * *,~ ** ** ,~*,~ -;: ,': -;:,~,~ ,': -;: -;: -;: ,': <br /> <br />PLUMBER Company <br />State Cert. or Regist. 0 <br />Signature City License Registration il <br />**************~***+~********************** <br /> <br />MECHANICAL Company <br />State Cert. or Regist. 0 <br />Signa ture . Ci ty License Regis tration ii <br />****************************************** <br /> <br />OTHER Company <br />State Cert. or Regist. # <br />Signature City License Registration # <br /> <br />APPLICATION APPROVED BY .PERl'lIT OFFICER. <br /> <br />