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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT 1JJj 'C C~Me II e",~ t~.',^, (0. 1;.e <br />ADDRESS :l.7l./2'? .:5RSL/,. 1A1,:}(~v Cf,~/?{'I (:=( <br />OWNER Si 'Jv'~ cJA-kS G61-t- -r a~Y"ltilV ((vb T~t. <br />JOB LOCATION <1' '641 QLb A.f)ustc <br /> <br />PHONE('?J'I3)c; 73 -C(cr77 <br /> <br />OJ). <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. 4~ <br /> <br />-;<(;-~l -12-0 <br /> <br />WORK PROPOSED:-2L-New Construction ____Addition <br /> <br />Iteration _Repair _Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />_Hove <br /> <br />_Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />_M/F <br /> <br />_4~ of Units <br /> <br />__N/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: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORNS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <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 />GAS <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 /> <br />CONTRACTOR SECTION . /1 / /" ]; <br />Company Nt '!...~NII(t:J/ (aIlS"'_ (0. C <br />State Ce~.t. or Regist. !F~6(087Cj'l/ <br />City License Registration ii .:27::/ <br />****************************************** <br /> <br />ET.ECTRT CT AN Company n'1 (I C In.un c'JrcJ 1 i (!- " __ <br />,)' , _ State Cert. or Regist. IF _-jl_ cCjla'::)~ <br />Si!!natured\L~ili~LX)\~ IT\. _ City License Registration iF . ::It-Iq~- <br />*********************************wv**w***w <br /> <br />PLUMBER Company ~;e~. (u.""&~. $- <br />State Cert. or egist. i.! CFCD..2C;y/tj <br />Signature ~ City License Registration iF /-21 <br />************************************* <br /> <br />... <br />MECHANICAL Company ~~o..~", ~o"'<'~ \o~~~ <br />State Cert. or Regist. ;F~ 3. 'i, <br />Signatu~n.. ~C\ C~J~""'-' . CiLy License Registration ii IICl~) <br />****************************************** <br /> <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />