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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />XI ~ 5Y rA-' Ir~ <br /> <br />/r/~I V--/~ <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />JOB LOCATION <br /> <br />!? a-d/ j2, /z 0 cP r1 <br /> <br />xSOO:) 'I- 59067 /0 "t-"f-OQ LOT SIZE_X <br /> <br />" <br /> <br />OWNER <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. t~ <br /> <br />WORK PROPOSED:____New Construction _Addition _Alteration ____Repair _Ins tall <br /> ____sign/Temp. _Sign _Hove _Demolish <br />PROPOSED USE: ____Single Family ~/F _t~ of Uni ts ,._H/H <br /> ____Commercial _Indust. ____Swim. . Pool Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <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 FORt-IS. ,H <br />**COPY OF CONTRACT REQUIRED. <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />PERMTTS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />____MECHANICAL <br /> <br />~' AMP Service <br />~b 00. &0 <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />_ELECTRICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <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 />~ONTRACTOR SECTION <br />Company <br />State Cert. or Regist. 11_ <br />City License Registration # <br />****************************************** <br /> <br />nllTLDER <br /> <br /> <br />Company {:/.$'; C' /HSff. ~ <br />State Cert. or Regist. i~ if' -.S 7/ <br />City License RegistrMion" 5 <br />***************************** <br /> <br />Signature. <br /> <br />Company <br />State Cert. or Regist. il <br />City License Registration # <br />****************************************** <br /> <br />Company ;{;"" 5~ C a.-v~~/fvl -r!J!C <br />State Cert. or Re ist. i~ ,f<A8-0~~70 <br />City License Registration i! 71 <br />**************************************** <br /> <br />PLUMBER <br /> <br /> <br />Signature <br /> <br />Company , <br />i/ NJ? J State Cert. or Regist. i! <br />/:.- f \. /'CLt'~teity ~icense Registration i~ <br /> <br />*, -lrli";,;;;4 * t! tf * * * ~*,* * -A1.** * * t*J'k. ;'j ,',0{, * 1-,', ~ of" ** * * * <br />f";rl:?~L \~~,'-1h~'kA:~-" PERMIT OFFICER. <br /> <br />APPLICATION APPROVED BY <br /> <br />A \)\\\4..<;' + 1'5~ I q9/ <br />)\c'\ -\ e.. 0 -\! F- \ CJ'C\ ~ ~ <br />\1",,::,(' 0 -Q)u'\i\+~ <br /> <br /> <br />~"i i~ ' <br /> <br />.~. .. ~-', <br />