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<br />APPLICATION FOR PERI-lIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT 4 c ~ If e ff--I i -fl, r ~ ho{~ ~tv G . " <br />ADDRESS Q)"l W. /lr1Plh1ortt').( a It'd. )f}~ei-l9l"j 1J}"OfpHONE (:fYJ) ~f>? 2. z.:J? <br />OWNER Do;-o +A J} S (0 (17 dh-J <br />JOB LOCATION '/(, $10 tfl-for c.e.. Sf 1. epiYki'rfLr 3JfY(OT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />015....0 <br /> <br />BLOCK~aQO<::) SUBDIVISION 0 j.Jo () <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL 1. D. ~~ <br /> <br />WORK PROPOSED:____New Construction _Addition _Alteration _Repair _Install <br /> ____Sign/Temp. _Sign _Hove _Demolish <br />PROPOSED USE: ---,-Single Family _M/F -~~ of Units .._M/H <br /> _Commercial _Indust. _Swim. , Pool Other <br /> <br />IV.... J-..."- 1-./ <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORNS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMTTS REOUESTEll <br /> <br />_BUILDING <br />V ELECTRICAL <br />V MECHANICAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida power Corp. <br /> <br />_W.R.E.C. <br /> <br />$ <br /> <br />/ '7 rs.o 0 <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />-~ ~ . <br /> <br />TYPE OF CONSTRUCTION: ____Block _Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />Signature <br /> <br />~ONTRACTOR SECTION <br />Company <br />State Cert. or Regist. ~ <br />City License Registration ff <br /> <br />/U2' 7!?}1i::;;":::::::';:'~';;~';:~:':':;~". _ p" c . <br /> <br /> <br />State Cert. or Regi~t. i~ 1-:-500000(,/ <br /> <br />City License Registration ifr (J/IItj <;'1 7 <br />****************************************** <br /> <br />nllTLDER <br /> <br />f,T.F.CTRTCTAN <br /> <br />~ <br /> <br />Signature <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 6 <br />City License Registration ff <br />****************************************** <br /> <br />(". Ii C- - J') 7.rF <br />~ <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Comp:my lie e 17 e~h( ~R I~ ,+--r~;" <br />~~ State Cert. or Regist! ~fr C fJ.c. () <br />iA/X(}j City License Registration 1.~ <br />.. .............................*'.. <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration ff <br /> <br />f/f'C, <br />J ? 7J-~- <br />C-y '3 <br /> <br />llECIlANTC(: <br />Signatur ~vU2/ <br /> <br />Q'J'HER <br /> <br />APPLICATION APPROVED BY <br /> <br />~************1:************************* <br />, "-d ~"A~-W-- , <br /> <br />PERMIT OFFICER. <br />