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<br />APPLICATION FOR PERI-lIT <br />CITY OF ZEPIIYRHILLS <br />BUILDING DEPARTHENT <br /> <br />ADDRESS <br />OWNER Cd L; b' <br /> <br />JOB LOCATIONSI '30 rI GALe . 8t.-tJ \).# <br /> <br /> <br />(~LPIIONE3m ~:S9b~39rf"' <br /> <br />APPLICANT <br /> <br />~. <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. ~~ <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 />____~~ of lTni ts <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: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF nUILDING 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 />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />~MECHANICAL <br /> <br />AMP Service Florida Power Corp. <br />$ ~ 7 00 Valuation of Mechanical Installation <br /> <br />\-l.R.E.C. <br /> <br />... <br />. . . <br /> <br />_PLUMBING <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 />SiC'Ynature <br /> <br />Company <br />State Cert. or Regist. n <br />City License Registration n <br />****************************************** <br /> <br />ELECTRTCTAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration n <br />****************************************** <br /> <br />. PUJMRER <br /> <br />MECHANICAl c/ Company <br />(')[\ (,\/-C ') * State Cert. or Regist. ii <br />Signature K:M..u. ~ ~CL. . City License Registration i! <br />*..... .......................****.******. <br /> <br />If');:;), <br /> <br />OTHER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. n <br />City License Registration n <br /> <br />APPLICATION APPROVED BY <br /> <br />****************************************** <br />11 ,::.l:./h...f'.--01 A1 ' Q/)AJ'I/f) <br />\j <br /> <br />PERl'lIT OFFICER. <br />