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<br />APPLICATION FOR PERMIT
<br />CITY OF ZEPHYRHILLS
<br />BUILDING DEPARTMENT
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<br />APPLICANT
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<br />ADDRESS
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<br />PHONE
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<br />/J~:~ 77;F
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<br />S/r/ 'fi: F>>)J/~--('
<br />OWNER;~.dri f' ,;: :""' ,
<br />JOB LOCATION ' r, i r." ~..;;~~Y'f:- w r.~' ' , '
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<br />LOT SIZE X' AREA SQ,FT.
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<br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION 2/lt\\ s c.c\o '^'1 Co fIi\:~~l '
<br />PARCEL .I.D~~I,'lnI1!?'t~'h",~;te~' r;(' ()!1/(J Q~60 ()(J 00
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<br />WORK PROP~SE~\ .1. N"~fl<=~n~!~~~tion "..;.-A?cli:tion . ---.J\lt~r~~i~r,
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<br />PROPOSED USE: --..;..Sinsle Family'''' ..4;.:..::.:......Jf/F .'! , '_41'ofi'UnitS
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<br />'_Co.ercial , " '--'::"":'Indust. _Swl114 :Pool
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<br />.---.Jepair: ,,'.'1'<:. Install'
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<br />~Move',,~ ~ ; t~Hf~!'tiell~lish
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<br />Other
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<br />,...f, ~es tau~..n~ ' ~ i~eal~ ipepar.tII~ntt, ~pt)rovall:
<br />BUILDING SIZ~':'l 01 j~ .,1' x' .'1 '1:'11";t,~:" ,'"t.,,:. Square' Feet,'~'~'
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<br />Height
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<br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF ,BUILDING PLANS & (1) SET ENERGY FORMS.**
<br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & !(l> SET ENERGY FORMS;** ~ ,
<br />, ;,,' "tr*COpy . O~ ,CQNTRACT REQUIRED,
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<br />PERMITS RROUESTED '
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<br />_BUILDING, :: ,:' ,-" $ ,
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<br />, Valuation of Total ,Construction
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<br />, " Florida Power' 'Corp.
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<br />_ELECTRICAL".~ '
<br />~ECHANICA~ ' $
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<br />. <: II'
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<br />. AMP, Servi~e .
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<br />W.R.E.C;
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<br />Valuation of Mechanical Installation
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<br />_PLUMBING <'.,.;.,'..', ,I.",; ." ~ , .
<br />". ..,; :~ GAS ",,"~i:r ;.'
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<br />ROOFtNG "
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<br />, . ,?, ,I> ' SPECIALTY.,
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<br />TYPE OF CONSTRU~ION: ' _Block '~Frame';
<br />FINISHED/FLOOR ELEVATIONS:' "PT.
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<br />Other
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<br />Signature
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<br />******************************************
<br />CONTRACTOR SECTION
<br />Company
<br />State Cert. or Regist, #
<br />City License Registration #
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<br />BUILDER
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<br />ET.F.CTRTCT AN
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<br />Company
<br />State Cert. or Regist. #
<br />City License Registration #
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<br />Silmature
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<br />PLUMBER
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<br />Signature
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<br />Company
<br />State Cert. or Regist, #
<br />City License Registration #
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<br />Company 1?1'-11 tl-Rf;J 'j A-6.e.~ - A life. otii
<br />State Cert. or Regist. '41 c.,.. e.c .3.(V9(
<br />City License Registration #
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<br />Signature
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<br />OTHER
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<br />Signature
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<br />Company
<br />State Cert. or Regist. #
<br />City License Registration #
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<br />APPLICATION APPROVED BY
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<br />PERMIT OFFICER.
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