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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />tf)fd I~/<?:) ? 12, j-~ <br />7'-~)-7 / <br /> <br />APPLICANT --ki ~()f1 rt::YYlrRllC'-n(Y1 <br /> <br />ADDRESS ~=) -\ ~S S. t<. :=:>4 Lt ~ ? -~ ~ ~~ PHONE 'A\ 2):- -l~ -dSdS <br /> <br />OWNER J. \'E~, ~~, ~ \ (' K.ll J ~ <br /> <br />JOB LOCATION i.\ ~ 3C, U R ~+r .Q.cr LOT SIZE 5() X l.c,() AREA SQ. FT. 1, C:--.J:f:) <br /> <br />LEGAL DESCRIPTION: LOT(S) 3 -S BLOCK 15 SUBDIVISION Gm\l'j~ ~~V'E~l- ortrlLh6~ <br />" ., . . _ _ _ '"'M'3-.1- ~R:~ 5-, . <br />PARCEL i':'D.4f' efl /-e:l tr-/4- OD/U- 0/.6 - DO- 003fJ <br /> <br />. -.'. -,..--:;;? <br /> <br />~.. '_W.QRK..~ED :_New Construction ~ddition ~lteration ~epair _Install <br /> <br />_Sign/Temp. <br /> <br />_Sign _Move <br /> <br />_Demolish <br /> <br />PROPOSED USE: ~Single Family <br /> <br />----H/F _# of Units <br /> <br />__M/H <br /> <br />_Commercial <br /> <br />_Indust. _Swim. Pool <br /> <br />Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />X <br /> <br />Square Feet, <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 />-K.-BUILDING <br /> <br />$ 5/4 \S , rf"} <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />...- <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: FT. <br /> <br />~'\ <br />p'.I1MBBE ~ <br /> <br />Signature - <br /> <br />****************************************** <br />CONTRACTOR SECTION " <br />Company '--k\,.~ O~ 1. (~t10'L) llliC', , <br />State Cert. or Regist. IF ('-..p.[1 O~'5134 <br />City License Registration IF <br /> <br />......:::::**j:;:;;(!i~t ~~ <br /> <br />State Cert. or Regist. IF .L.. '" <br />City License Registration IF /,~57 <br />**************************X*(::J*~\******* \/, I \ ~ ' <br /> <br />Company ~. J ~~ ..-{ \1 v~\.O \ 1/ <br />d I State Cert. or Regist! IF RF () o5'~y;?4 <br />VIJ. ~ City License Registration IF .I d.. 5" <br />**~************************************** <br /> <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration IF <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. IF <br />City ~icense Registrat~on IF <br /> <br />OTHF.R <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br /> <br />PERMIT OFFICER. <br /> <br />.;. <br /> <br />-'_..:'.L._ <br />