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<br />------ <br />------- -- -- <br /> <br />APPLICATION FOR PERNIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTl'1ENT <br /> <br />I. ; <br /> <br />fA) c. /;~Y{,/4L sfkl AJ(,? ~ FG <br /> <br />f . . <br /> <br />PHONE /->>? -7 r..2 -u-S-f6 <br /> <br />OWNER <br /> <br />;<p,0 IAJ/LGY C/)A)S'T MI+/Alr <br />/2/'(- !?O!3uCI AJk' :> r f5())( S n ~ <br />M /2 a<- M /( <;. ~ . L -4!;!-A-f1:E-LL E3- <br />JOB LOCATION 39' 53b <br /> <br />LOT SIZE /!:..;,,\ /00 AREA SQ. FT. b ~ S-O f <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. iF <br /> <br />WORK PROPOSED:_New Construction ~Addition _Alteration ____Repair _Install <br /> <br />_Sign/Temp. <br />PROPOSED USE: ~Single Family <br /> <br />_Sign <br /> <br />_t-love <br /> <br />_Demolish <br /> <br />~/F <br /> <br />_iF of Units <br /> <br />,._M/H <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />_Swim.. Poo 1 <br /> <br />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 />COl-frlERCIAL : <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 fOR1'lS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMTTS REOUESTED <br /> <br />LBUILDING <br />lC-ELECTRICAL <br /> <br />$ <br /> <br />IS( H-1) Valuation of Total Construction <br />. I <br /> <br />AMP Service Florida Power Corp. <br /> <br />_\-I.R.E.C. <br /> <br />_MECHANICAL <br />-X-PLUMBING <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />'" <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_Frame _Steel IfLf/MIJUlIM Other <br />IJDIJE LoAo f;E/tt1lIJCJ6 aJJDU F~E <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />* **** *1<*1:*.************* * * ** '1,,~ * 1, * .:, ,', 'I: i: ,', ,': * 1, * ,', <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br />tJlI.-E^j (I)/<Jc.;r- UN Ai 1Company <br />."'\ __ 1i4j. State Cert. or ReGis t, !I <br />~ ~ City License Registration <br />* ****** ************ ** *,','1,ir*ir* i, *1r ,', ,', ,',;, ,',;, ,',1, ,', * <br /> <br />ET.ECTRTC1 AN (VJ (fir + i iI\ E I Q... L. -+ r; e-. Company <br />~ fl /}) j State Cert. or I~egist. II <br />Sil?nature r~~ 17-. 11A...,;,~ City License Registration II <br />********~******************************** <br /> <br />I{GAJ <br />~~ <br /> <br />RUTLDER <br /> <br />II .41'''-'''~ {.. ? <br />M AS.OA>/2y 1- { <br />{~ItRPPtJ"/IZY s?f 3. <br /> <br />6/200{)/l0 <br />1St <br /> <br />PLUMBER 711V1 M 4- 711 C ;;::=. Company <br />State Cert. or Regist, 0 <br />Signature City License Registration ;1 l-r-/ <br />****************************************** <br /> <br />MECHANlCAL-_ <br /> <br />Company <br />State Cert. or Regist, 0 <br />City License Registration 0 <br />****************************************** <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regis t, II <br />City License Registration 0 <br /> <br />.Q.T.HER..-__. <br /> <br />Signature <br /> <br />***********!t***************************** <br />APPLICATION APPROVED BY -jlO-l1A1/e] &L~r , . <br /> <br />PERt-lIT OFFICER. <br />