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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT -df~EMICK 5Ltf\1COA:;;;-r <br />ADDRESS 3/7321)5 K. 54 ~v. <br />730/3 (Y H~W[~ <br />JOB LOCATION 5J3{) /~~ 711 Sf-. <br /> <br />, t-2o () r-- OJ C1 , <br />~ <br /> <br />7; .1-11 LLS 335 iff <br /> <br />~lC, <br /> <br />PHONE <br /> <br />St3~ q ~ 2 - (oOCf'-f <br /> <br />OWNER <br /> <br />LOT SIZE <br /> <br />x <br /> <br />AREA SQ. FT. <br /> <br />" <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D .l~ <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 />____4~ of Uni ts <br /> <br />,____M / H <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 Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <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 FORMS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PF.RM1TS REOUESTED <br /> <br />~BUILDING <br /> <br />$ <br /> <br />I f 5- 0 . 00 <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 />x <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 /> <br />Signature <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />)3~J1T,DER <br /> <br />SiQnature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # . <br />****************************************** <br /> <br />ELECTRTCTAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 4~ <br />City License Registration l~ <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />MECHAN1CAL <br /> <br /> <br />Company f>r2Ei)7 / ERE St u\./t[lfi S- r !{CC''{.I N4I1v C. <br />State Cert. or Regist. # ,R.C u()(.oliL.7t.!-Y , <br />City License Registration 4F fr _')-f? <br /> <br />*** it'; * *1* *****t;~~:~ ** * ** * ** * * *,.ft* * * ** * * * * * <br />'. ....-; /Xl ,'-;~~ /J } .::; / ~ ' PERMIT OFFICER. <br />