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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYFHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />CHURCH OF GOD <br /> <br />PASTOR HERMINIa ORTIZ <br /> <br />ADDRESS <br /> <br />39440 Lincoln Ave. Zephyrhills FL. <br /> <br />PHONE (A 1 i) 7 R l 76 e 4 <br /> <br />OWNER Same as applicant <br /> <br />JOB LOCATION <br /> <br />Lincoln Strep.t <br /> <br />LOT SIZE~X (Q 0 AREA SQ .FT. <-/_9JJ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION. <br /> <br />PARCEL I.D.~f <br /> <br />12-2h-?1 <br /> <br />n?Rn OOOQQ 0220 <br /> <br />WORK PROPOSED:____New Construction ~Addition ----Alteration ____Repair ____Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />_Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____4F of Units <br /> <br />_____M/ H <br /> <br />____Commercial <br /> <br />____Indust. <br /> <br />____Swim. Pool <br /> <br />class rooms Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: 10' X in', <br /> <br />QQQ liIq ft_ <br /> <br />Square Fee t, <br /> <br />10' <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />**COPY OF CONTRACT REQUIRED, <br /> <br />PERMITS REOUESTED <br /> <br />-1LBUILDING <br /> <br />$ 6,500.00 <br /> <br />Valuation of Total Construction <br /> <br />-LELECTRICAL <br /> <br />1c:;n <br /> <br />AMP Service <br /> <br />x <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />____MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />-X-PLUMBIN'G <br /> <br />0"" <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ~Block ____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />* <br /> <br />FT. <br /> <br />* Same as existing floor* <br /> <br />****************************************** <br /> <br /> <br />CONTRACTOR SECTION <br />Company Delaf ield ConF;r rllr-r inn <br />State Cert. or Regist. 1F 104/n01990 <br />City License Registration lFC'nllnty #G 1 Q <br />*************************************** <br /> <br />Ei I? ~-- /)- ~ '--5 C I <br />Company . <, L l v . . _) F . <br />State Cert. or Regis t. iF E /2. CJ 0 t/ ~-/ 7 <br />City License Registration iF /..5 ';1 <br />***************************************! ' <br /> <br />PLUMBER Richard Delaf ield Company f)~l&l f i91d ConotructioIJ <br />State Cert. or Regist. 1,! 130 JRPOOJ02:::;7 <br />Signature City License Registration iF fOtluL -11-002350 <br />****************************************** y <br /> <br />Company <br />State Cert. or Regist. iF <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br /> <br />OTHER <br /> <br />Signature <br /> <br />if <br /> <br />* <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />