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<br />APPLICATION FOR PEmlIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER <br /> <br />/)A-t/~~ T ~ ~,I <C~ C~ <br /> <br />/ :P (Pi t:: t. (A:f{': ~' r <br />c:-" ~ I <br />Uu A) L .; A A-I ~ <br />t ........ <br /> <br />JOB LOCATIONSr3j- GdLL- <br /> <br />APPLICANT <br /> <br />PHONE <br /> <br />y3't' (C'&-~ <br /> <br />ADDRESS <br /> <br />-&o'-.C V4t'~ <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D .l~ <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install <br /> <br />____Sign/Temp. <br /> <br />_Sign <br /> <br />_Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />_M/F <br /> <br />_i~ of lIni 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 Fee t I <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 FORMS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />pERMITS REOUESTED <br /> <br />____BUILDING <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 <br /> <br />_Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTI~ I ~ ,- <br />Company ~tl-U{:' r ~ .. S~ { (:) .'.- <br />State Cert. or Regist. i~ CJ (+Q (/-'O ~;, <br />Ci ty License Regis tra t ion ii ;;;:! '-12... -- <br />*************************************** <br /> <br />~ <br /> <br />ELECTRICIAN <br /> <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration ff <br />****************************************** <br /> <br />Signature <br /> <br />Siunature <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAl. <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. ff <br />(J City License Regis tration l~ <br /> <br />i.....~***. <br /> <br />DTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />~*** <br /> <br /> <br />PERNIT OFFICER. <br />----- <br /> <br />cJ1, JL/U}0 <br />