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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT ?~JI e~'C; bjtI R- P ,U,( m h iA) h <br /> <br />ADDRESS 0 _ 3 3' /J10~tS/ <") /312 ,~t' M PHONE <br />OWNER !>if.. II ct n k I 'A <br />. <br /> <br />b/ ~S5 <br /> <br />7Rl- 2_ S:Lt; <br /> <br />JOB LOCATION <br /> <br />)", ^i11l eT <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. iF <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 />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____iF of Units <br /> <br />.____M I 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 />A TT ACH (3) SETS OF BUILDING PLANS & (1) SET EN ERGY FORI-iS. *-1: <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PF.RMTTS REOUESTED <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 />_\-l.R.E.C. <br /> <br />____MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />____PLUMBH[G <br /> <br />0'" <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 SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Sif!nature <br /> <br />Company <br />State Cert. or Regist. n <br />City License Registration # <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />~IUMBF.R 2i . Company ML<; gd/ll{ e{:( ~1/;&i: c <br />~ State Cert. or Reg"t. " 00 <br />Signature(:; 'Ad 2{ hJ.. City License Registwtion " .'07 <br />. ****************************************** <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />OTHER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. ~ <br />City License Registration 1 <br /> <br />APPLICATION APPROVED BY <br /> <br />~c:::;~.~:~::~::*....*~.*.****.**** <br /> <br />PERMIT OFFICER. <br />