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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />till At,' /J /"'.. f) I/:'e~, <br />~ l.J. {/Yi;nU.t/YJ :1.. ~U~~ <br />ADDRESS 38'--130 &u'-/11 A v~~ 0 PHONE ~ 8 f:.3 - BaL-I'-1 <br />OWNER I-tLt-nhJ~rl f/ 4/l'cr::, V()nd~r (Y)(4j llFJYl <br />JOB LOCATION 612J 2~, C{f;, <br /> <br />~ <br /> <br />--H4LUo <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL I.D.~F / /- 2G7'~ 2/ <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />enlC) -O'78CD -CC1'75 <br /> <br />~epair <br /> <br />_Install <br /> <br />WORK PROPOSED:_New Construction ----Addition ----Alteration <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 />_~F of Units <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 />PERMITS REOUESTED <br /> <br />V/BUILDING <br /> <br />$, ? S . C--D, C,--' <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\-V.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBIN'G <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 />Signature <br /> <br />CONTRACTOR ~ ~ ^ Cnl <br />Company . W . A I urn kr)~~ <$ (I vefe <br />State Cert. or Regist. iF .>t 0 /tlf J <br />City License Registration #- 9 <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />ELECTRICIAN <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. ~F <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 /> <br />'-/1 ""'<< 'c~ ;Y ,A ",""- , <br /> <br />PERMIT OFFICER. <br />