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<br />APPLICATION FOR PER1'lIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT !Ie 4. f1 e +f-flf..e j-ftf(c/r- Y;tJC <br />I <br />ADDRESS q 2-3 U/. i111.L m or-r'n-L (J I rei. j nil.. e t.nAJ <br />OWNER Dol"o f-~ 115/0 r It drd <br />JOB LOCATION 'I" va )..&/01- c..(. [( <br /> <br />J }yO! PHONE( 3'1 J/)' <0 P? - }... 2. ] Y <br /> <br />'. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 1. D. ~~ lif - ~ 10- 'L ( <br /> <br />Z-p~q^lt~ -':JJSY( LOT SIZE_X <br />, <br /> <br />CJ /5'0 <br /> <br />AREA SQ. FT. <br /> <br />BLOCK 00000 SUBDIVISION 0 J 6 0 <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 />_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 FORMS.** <br />**COPY OF CONTRACT REQUIRED, <br /> <br />FF.RM1TS REOUESTED <br /> <br />_BUILDING <br />~ELECTRICAL <br /> <br />$ <br /> <br />g75.oa <br /> <br />Valuation of Total Construction <br /> <br />/ )<5 AMP Service <br /> <br />Florida power Corp. <br /> <br />~ <br />51)':0" <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 _Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />~ONTRACTOR SECTION <br />Company <br />State Cert. or Regist. n <br />City License Registration # <br />****************************************** <br /> <br />lW1LDER <br /> <br />Signature <br /> <br />::::::::::~.. _ K~ Company IJ c..e 17 Q ~ r~91l ,. If trot' .J: /~ G <br />State Cert. or Reg1st. ~I [; s C) 000 0 ~ ( <br />. . Ci ty License RegiS t ra t ion " y,/ 7 . <br />****************************************** <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />_ Company <br />~- ~~ State Cert. or Regist. ~F <br />I h V/lJI City License Registration iF <br />*** ***************'fd'******~'*****~ **1, <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />MF.\.HANTC~ <br />Signatur /~~ <br /> <br />DTHER <br /> <br />****************************************** <br /> <br />PERMIT OFFICER. <br /> <br />APPLICATION APPROVED BY <br />