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<br />APPLICATION FOR PERMIT <br />CITY OFZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />J; <br /> <br />/IN#' ~.ek4/ / <br />7~ ' ~ <br />/~ sT ;?-#,L/ <br />~~~// <br />T* ~ <br />/~ S-/ z- ,~L <br /> <br />;?e///y/C' ~-ee <br />PHONE ~?,-.3~d.R <br /> <br />JOB LOCATION <br /> <br />1//;2.. <br />,J; ,HWAI <br /> <br />/1/2- <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. t~ <br /> <br />//--02~-,~/- 00/0 '- CJ6000 .,-tJ/3/ <br /> <br />/3 <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 />_t~ of lTni ts <br /> <br />.____1-1/ II <br /> <br />_Commercial <br /> <br />~Indust, <br /> <br />_Swim: .1'001 <br /> <br />Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Fee t, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />COMl-IERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORl-IS. ** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />-K-MECHANICAL <br /> <br />AMP Service <br />/Olg',b" 03 <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBIN'G <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 />Signature <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. 0 <br />City License Registration ~fr <br />****************************************** <br /> <br />BUILDER <br /> <br />ELECTRTCTAN~- ~,~~Q.\ Q.I....~ .., ' Company L -' \A.\\...\.....!; El....0c..-...... <br />~ State Cert. or Regist. il <:=0 :2,.l(.,'?' <br />Signature ' .' "",' City License Registration;) LO <br />- ,,**************************************** <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration j~ <br />****************************************** <br /> <br />PLUMBER <br /> <br />MECHANICAL .:Ji//AI r /(/l/lf/e-.V ,', Company ;?e~//Y~ ~/ee <br />~ ~ / State Cert. or Regist. " .M&otG.t?6Z,O <br />Signature /' ' City License Registration ;'~ ?? <br /> <br />, . ... *~****' *......**...**...,.,J,J,J..,.J.....cJ.J.J..CJ.J..,.J- <br />.... ... .. ........ n n.' .' .. .. .. .. .. .- .. .... .. .. .. .. <br /> <br />PTHER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration r <br /> <br />APPLICATION APPROVED BY ~;;~.::~..~~~.;;:~**.~****<**:.*** <br /> <br />PERl-lIT OFFICER. <br />