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<br />APPLICATION FOR PERNIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />7 !!- C It:, // - ,Ntr~C-r <br /> <br />APPLICANT <br /> <br />Ut2,.J}'.l/ S <br /> <br />/ hA~~ ' <br />K~~~L //7 If rv d PHONE (rt 3) !~ i'- 71 ,,-1 <br />,/'1 Cf R"/;ft..r ' <br />. , Zc (f It t LA" )JJ <br />7-(........ ftv'<l. j ~S9AoT SIZE_X AREA SQ.FT. <br /> <br />ADDRESS d- f"1 ( tJ ' <br /> <br />OWNER <br /> <br />~AVO/"\\A <br /> <br />JOB LOCATION :J I ~ a-o <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D .1t <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration _Repair ____Install <br /> ____Sign/Temp. ____Sign _Move ____Demolish <br />PROPOSED USE: ____Single Family ~/F _~~ of Units ' .____M / H <br /> ____Commercial _Indust. ____Swim. Pool Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />,.,J..,<{(rO 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 />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR}lS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />FERMTTS REOUESTED <br /> <br />,/ BUILDING <br /> <br />$ ~Y;)D~ <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 />v <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 />BUTT.DER J)"'1 =<...... ( <br />Signature J:)~ <br />v <br /> <br />/J -f ~ONTRACTOR ~ /J I-~ <br />f(."" ,,.') 'company<;)rA~ /)1'-1 }'Co." rr-r) <br />, A- ,State Cert. lr Regist. iF "Co 0 G:, 0 &0 ~ <br />RU-e- City License Registration IF ~7 <br />****************************************** <br /> <br />Si2nature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />f.T.ECTRTC1AN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />tlECH.AlU CAT, <br /> <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Company <br /> <br />Signature <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration # <br /> <br />OTHER <br /> <br />****************************************** <br /> <br />PERMIT OFFICER. <br /> <br />A~PLICATION APPROVED BY <br />