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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />M If ~/(JV1 'P-b1TfJ .J- J~ L ~A:( () r--e.- <br /> <br />, <br /> <br />JOB LOCATION <br /> <br />W(J "7-1 <br />f~" <br />~'f <br /> <br />l/~ 5r <br />rH A-,h~ <br />I /t- b () vJ. 5 (l-~ ,9,"0 , <br /> <br />PHONE <br /> <br />7g-5 -. ?6qtt <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />LOT SIZE l r-,'{ 12.::>-;REA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.l~ 02-'1-rc-U-6/!":O _t)()(),tlO -d{I,L) <br /> <br />WORK PROPOSED:____New Construction ----Addition ____Alteration ____Repair ____Install <br /> <br />____Sign/Temp. <br /> <br />_Sign <br /> <br />_Hove <br /> <br />____Demolish <br /> <br />_Indust. <br /> <br />~Units <br /> <br />wim. Pool <br /> <br />.____M / H <br /> <br />PROPOSED USE: _Single Family <br /> <br />_M/F <br /> <br />____commercial <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 FORHS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />~. f/c'Z> <br />____BUILDING $ <br />_ELECTRICAL AMP <br />____MECHANICAL $ <br />_PLUMBIN'G GAS <br /> <br />c~ Valuation ~otal Construction <br /> <br />Service ~ Florida Power Corp. <br /> <br />_H.R.E.C. <br /> <br />Valuation of Mechanical Installation <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 SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration ~ <br />****************************************** <br /> <br />BUILDER <br /> <br />Si!!nature <br /> <br />Company <br />State Cert. or Regist. fl <br />City License Registration ,1 <br />****************************************** <br /> <br />El.ECTRICTAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. Q <br />City Lic~nse Registration # <br />*************************************~**** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert, or Regist. 0 <br />City License Registration # <br /> <br />OTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />~~***********~************************** <br />~ ^ '^ (J A <<j~"7--' - <br />. ~ <br /> <br />PERMIT OFFICER. <br />