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<br />APPLICATION FOR PERl-tIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT .AIIY' <br />ADDRESS };2-y: <br /> <br />.>1<<)(' /",1' ' <br />/1. <br /> <br />PHONE <br /> <br />JOB LOCATION <br /> <br />// J~, J /jl/ <br /> <br />'. <br /> <br />OWNER <br /> <br />LOT SIZE~X /..5fJ AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />/ / -;( ( -,;2 J <br /> <br />BLOCK SUBDIVISION <br />?J 0/0 ~ / ~/ (/ rJ ..; 00 j-' 0 <br /> <br />WORK PROPOSED:____New Construction <br /> <br />____Addition ____Alteration ____Repair <br /> <br />tin f/J;iJt <br />.-LIns talljll.ff. f .fi:('€ <br /> <br />PARCEL 1. D. i~ <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />_Hove <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />~/F <br /> <br />_i~ of Units <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, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMNERCIAL : <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 FORHS.H <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 />_\-l.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 />S/Je,.~ Other <br /> <br />TYPE OF CONSTRUCTION: ~Block <br /> <br />____Frame _Steel <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br /> <br />* ***1,***1:*.**** ********* * *1,* 1",< ** * 1. 1, 1: 1: {: ,': * 1: * 1: <br /> <br />Signatu <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration II .:3 / ,!>'-" <br />******************************** <br /> <br />Si!!nature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration II <br />****************************************** <br /> <br />ELECTRTCTAN <br /> <br />Signatur,e <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration II <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration 0 <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration # <br /> <br />OTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />~*~::ij'~;~~""~***********" <br /> <br />PERt-lIT OFFICER. <br />