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<br />APPLICATION FOR PERNIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTt-1ENT <br /> <br />APPLICANT N G--\. <br />q'JeJ <br />~'1.L <br /> <br />, <br />~ (1"'-_ <br /> <br />~d~' <br /> <br />:Z.-- <br /> <br />OWNER <br /> <br />l...,.....-(J. Q'''"''t. 17 (iC:~ <br />CL~~~i5it-t- <br />JOB LOCATION )(")(; t.. f'O-AJdo veL <br /> <br />~ - <br />"2"r:; <br /> <br />u,..c: <br /> <br />PHONE <br /> <br />7~ J- '-- 'X1 '11 <br /> <br />ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />x )J AREA <br />(lLo lie. <br />I <br /> <br />SQ. FT, '7~.u <br />II i \\~'.A <br /> <br />LOT SIzF/Ou <br /> <br />PARCEL 1. D.iF '3:)- .) ') <br /> <br />J-\ <br /> <br />j- r1 <br /> <br />c-' <br /> <br />Lei- <br /> <br />WORK PROPOSED:~New Construction ____Addition _Alteration ____Repair _Install <br /> <br />_Sign/Temp. <br /> <br />____Sign <br /> <br />____~!ove <br /> <br />_Demolish <br /> <br />_Indust. <br /> <br />_I~ of Units <br />~im. Pool <br /> <br />,._t-1/H <br /> <br />PROPOSED USE: ____Single FamilY <br /> <br />~M/F <br /> <br />_Commercial <br /> <br />Other <br /> <br />BUILDING SIZE: <br /> <br />_Restaurant & Health Department Approval <br />"') 0 2,A r '5/' '1 3.sf <br />1'f x.:;), _ ~ Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COilllERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOIU-IS, ** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY rOR~!S. ** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERt-1TTS REOUESTED <br /> <br />_BUILDING <br /> <br />$ 17 96 ') <1'::-- <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp, <br /> <br />_H,R.E,C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />,- <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 />** ***** *1:*'************* * * 1:*1:'~ * 1: * ':, -I: ,', -I,;: ,', * ,': *-1: <br /> <br /> <br />Signature <br /> <br />CONTRACTOR S <br />Company <br />State Cert. or ReCist. !F~ <br />City License Registration 0 <br />****************************************** <br /> <br /> <br />:' :::~::A~ 1 Compony 'P-<~'< <:J;;,.... J~I <br />(_ State Cert. or H.egist. 11--21.."3 <br />: 0 - - - ~~. I*i~-:~:::.-:'::.. .~;~~.;;~:~~:.~; ~ ~: ~ ~~; ~~~ " <br /> <br />k-y. ~ &''''-. <br />+~l <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist, 0 <br />City License Registration 0 <br />****************************************** <br /> <br />PUJMRER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration 0 <br />****************************************** <br /> <br />MECHANICAl, <br /> <br />OTHER <br /> <br />Signature <br /> <br /> <br />Company <br />State Cert. or Regist, 0 <br />City License Registration 1 <br /> <br />I <br />-;':'dd:"~1::":i:*H PERMIT OFFICER. <br /> <br />APPLICATION APPROVED BY <br />