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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT '-:J (). m ~ C, / .t L Ai e I ~S() Y\J <br />. <br /> <br />ADDRESS ~ -) 3 ~ 7/ G.. ':~( r'l Y'\ t' .S) Y' <br />OWNER S('~())f~ 'AI N-i/..s{)Y'\ <br />JOB LOCATION .::) ..3c.J7 <br /> <br />2-k,l\ PHONE 78',;)'- fJ,")"// <br /> <br />'. <br /> <br />Tell':) P ,,', ne <br />.#-ID <br />LEGAL DESCRIPTION: LOT(S) __ <br />. <br /> <br />r~f' <br /> <br />LOT SIZE <br /> <br />x <br /> <br />AREA SQ. FT. <br /> <br />BLOCK <br /> <br />o SUBDIVISION 2. ~ rh~l r- <br /> <br />/-Je ij h t .5 <br /> <br />PARCEL 1. D. ~~ <br /> <br />WORK PROPOSED:____New Construction ____Addition ~Alteration ____Repair ____Install <br /> <br />____Sign/Temp. <br />PROPOSED USE: ~Single Family <br /> <br />____Sign <br /> <br />_t--love <br /> <br />____Demolish <br /> <br />--.-M / F <br /> <br />____# of Units <br /> <br />, .____M / H <br /> <br />____Commercial <br /> <br />_Indust. <br /> <br />____Swim.. Pool <br /> <br />Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: ..:JD X JJ) , <br /> <br />Square Feet, <br /> <br />gl <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 FORNS. H <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMTTS REOUESTED <br /> <br />--LBUILDING <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 />____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 />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. 0 <br />City License Registration ff <br />****************************************** <br /> <br />HUTLDER <br /> <br />Signature <br /> <br />ELECTRT ClAN 0 l.,dn fr Company <br />t9- ^ / State Cert. or Regist. tt <br />Signature /. ~W /y~ City License Registration tt <br />****************************************** <br /> <br />Company <br />State Cert. or Regist. tft <br />City License Registration ff <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration ff <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />OTHER h{)l'n Lt"Ildt':'lU' <br />Signature-)/.!Jllrnz.h W N~ <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration 0 <br /> <br />APPLICATION APPROVED BY *r;*j~"'"*.L~*~~**i5;?~'*~:1'********* PERMIT OFFICER. <br />