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<br />r <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />(1/!J 72!-66// <br /> <br />APPLICANT <br /> <br />WOfLS C~l <br />1~~qq )q <br />, <br /> <br />C() M fJft1J1 f5- ~ <br />z'$f'flY HJt{)' <br />fit.}; r r~- .. "} 1 f"c..r() <br />V I C TO /L Sm J rll <br />.-S /! mf <br /> <br />PHONE <br /> <br />7 J/ 3- /9%,3 <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />JOB LOCATION <br /> <br />LOT SIZE_X <br /> <br />AREA SQ,FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D .l~ <br /> <br />() ;) r ;"0 r- ;q -- 0& I rJ -- () ~ O(){) -- tJtJ 10 <br /> <br />WORK PROPOSED:____New Construction _Addition ~lteration ____Repair _Install <br /> ____Sign/Temp. _Sign _t-1ove ____Demolish <br />PROPOSED USE: ____Single Family _M/F ____# of Units ._M/H <br /> ~commercial _Indust. _Swim, Pool Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORI-IS.**' <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />LBUILDING <br /> <br />$ <br /> <br />5fJ{)'{}() <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 />_PLUMBIN'G <br /> <br />Gl\S <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 />BUILDER {)J()fl5 t-E Y <br />Signature Joy r7' <br /> <br />t~,1 5 CONTRACTOR SECTION <br />cO f11 ~{1JV / f ~ Company <br />~~~ ~i~~\~~~~~e o~e~~;~~;;' i~n il." I q /i1ft., <br /> <br />~************************************** <br /> <br />-/' <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert. or Regist, # <br />City License Registration # <br />****************************************** <br /> <br />Si!!nature <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. # <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist, # <br />City License Registration # <br /> <br />OTHER <br /> <br />. Signature <br /> <br />APPLICATION APPROVED BY <br /> <br /> <br />PERMIT OFFICER, <br />