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<br />APPLICATION FOR PERMIT
<br />CITY OF ZEPHYRHILLS
<br />BUILDING DEPARTMENT
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<br />APPLICANT
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<br />ADDRESS ~/)j'-(7:)
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<br />JOB LOCATION (~.~ 'i ()
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<br />LEGAL DESCRIPTION: LOT (S) (/c;J-
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<br />BLOCK
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<br />LOT SIZE 70 X )..h, AREA SQ.FT. ~7():.~
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<br />SUBDIVISION \). ()(/ ()r):S
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<br />PARCEL 1. D. ~~
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<br />WORK PROPOSED:____New Construction ~Addition ____Alteration ____Repair ____Install
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<br />____Sign/Temp,
<br />PROPOSED USE: ~Single Family
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<br />____Sign
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<br />_Move
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<br />____Demolish
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<br />____M/F
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<br />____~~ of Units
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<br />.____11 / H
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<br />____Commercial
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<br />_Indust.
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<br />____Swim. Pool
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<br />Other
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<br />_Restaurant & Health Department Approval
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<br />BUILDING SIZE: .::- X I ? ,
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<br />Square Feet, (L
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<br />Height
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<br />RESIDENTIAL:
<br />COMMERCIAL :
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<br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
<br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORNS,**
<br />**COPY OF CONTRACT REQUIRED.
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<br />PF.RMITS REQUESTED
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<br />V//BUILDING
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<br />$
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<br />Valuation of Total Construction
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<br />____ELECTRICAL
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<br />AMP
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<br />Florida Power Corp,
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<br />_W.R.E.C.
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<br />_MECHANICAL
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<br />Valuation of Mechanical Installation
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<br />____PLUMBIN'G
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<br />GAS
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<br />ROOFING
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<br />SPECIALTY
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<br />TYPE OF CONSTRUCTION: _Block
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<br />____Frame ____Steel
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<br />Other
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<br />FINISHED FLOOR ELEVATIONS: FT.
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<br />******************************************
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<br />CONTRACTOR SEC~. ~
<br />BUILDER Company!: (""il"C I (
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<br />Signature 9~,; /)y,~-(I ~~~~eL~~:~~eo~e~~~~~~~.i~n
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<br />/~ ,- ******************************************
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<br />Si!mature
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<br />Company
<br />State Cert. or Regist. 8
<br />City License Registration #
<br />******************************************
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<br />ET.ECTRTCT AN
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<br />Company
<br />State Cert. or Regist. ~
<br />City License Registration #
<br />******************************************
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<br />PLUMBER
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<br />Signature
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<br />Gompany
<br />State Cert. or Regist. #
<br />,City License Registration 4~
<br />********************************~*********
<br />
<br />MECHANICAL
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<br />Signature
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<br />OTHER
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<br />Company
<br />State Cert. or Regist. #
<br />City License Registration #
<br />
<br />Signatu~e
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<br />APPLICATION APPRQVED BY
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<br />PEllinT OFFICER.
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