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<br />APPL'ICATION FOR PERNIT <br />CI.TY OF ZEPIIYRHILLS <br />BUI.LDING DEPARTl'1ENT <br /> <br />APPLICANT CC;u...~ ~ \.G \EJ <br /> <br />?fi441.... ~L DJGi" <br />-V6\?,.C\- Goa~~ <br />JOB LOCATION 39~L- ~L Q.Q <br /> <br />()~ <br /> <br />~ ~C\6cL C~QQ-~~~~ <br />PHONE 7.S'~ JhS(~ <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />" <br /> <br />LOT SIZE 7. 0 X / / "C) AREA SQ. FT . <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 1. D. ~~_\ ") - "2io - -:2- \ <br /> <br />BLOCK SUBDIVISION <br /> <br />Q~01:) D~~t::J - O~<Sb <br /> <br />WORK PROPOSED:_New Construction ~Addition _Alteration _Flepair _Install <br /> _Sign/Temp. _Sign _~love _Demolish <br />PROPOSED USE: __'_Single Family ~M/F _i~ of Units , __1'1 I H <br /> _Commercial _Indust. _Swim. Pool Other <br /> <br />BUILDING SIZE: <br /> <br />_Restaurant & Health Department Approval <br /> <br />'?-. X (0 ,40"1 L-i .J 'SZ~qU'Te Feet, ~ ~ Height <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 FORl'IS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />PERMITS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />V~luation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />_Florida Power Corp. <br /> <br />_h'.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 <br /> <br />_Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br /> <br />CONTRACTOR SECTION <br />Company -J....~ ~c.~ '- ~, <br />State Cert. or Rcgist. lj <br />City License Registration lj <br />****************************************** <br /> <br />~ <br />~re <br /> <br />Si2nature <br /> <br />Company <br />State Cert. or Regist. U <br />City License Registration 0 <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert. or Regist. 4! <br />City License Registration U <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration # <br />***********************~****************** <br /> <br />MECHANICAl, <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration 0 <br /> <br />OTHER <br /> <br />Signature <br /> <br />**,!!* ** ** ******1)j***** * * *, ** *~,* of,." "','" of, -I, *"';- -I, * -1,-1, <br />APPLICATION APP,ROVED ~Y 71 ~/~{ .~_O/L-r,~'~"", , .. <br /> <br />PEmnT OFFICER. <br /> <br />-'..J <br />