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<br />AFPLioATXON FO~ PE~I~T <br />C~TY OF ZEPIIYRHILLS <br />BUILDING DEPARTMENT <br /> <br />ADDRESS <br /> <br />I' ' " , , <br /> <br />\/\X~.L \~I~ ~~ \)~'\\ \ ~\\\~~\\ ~ ,\\~~Sf \)~~\~) lJ <br />~\ \~L\ L(~~ \~ L~\)~ ,1fu\;\;~ <br /> <br />OWNER ~~\') 'V. ~()." . ~\"'<.:~~{'\ <br />JOB LOCATION ~~\~~ \\\<0C-',V\~ \\\\y/ <br /> <br />LEGAL DESCRIPTION: LOT(S) ~ BLOCK G <br />\J.- 1\D~ ~\" ~U~~ - DDGb\J - UhlD <br /> <br />..,; ( <br />fl.of.lli[j' ~ C . <br />PHONE-D ~ I~'- \ c, 3~ <br /> <br />APPLICANT <br /> <br />" <br /> <br />LOT SIZE~X \~U AREA SQ.FT. <br />SUBDIVISION 1,(" Pt\;\\l) , \'\\f A~ ~Th <br /> <br />PARCEL 1. D. i~ <br /> <br />WORK PROPOSED:____New Construction ~ddition -LAlterntion ____Repair ____Install <br /> ____Sign/Temp. _Sign _Hove ____Demolish <br />PROPOSED USE: ~Single Family ~/F _i~ 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 Fee t, <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 FORl'1S.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PF.RM1TS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />!b\'J tJ ,\j~ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />ANI' Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />____MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />J <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 />****************************************** <br /> <br />Signature <br /> <br />CONTRACTOR SECJION , <br />Company , ~ , <br />~. /) I) 7 State Cert. or Regis t. iF <br />(...-A./t-t' (./0' o-o-t City License Registration <br />****************************************** <br /> <br /> <br />ntJlLDER <br /> <br />Sirmature <br /> <br />Company <br />State Cert. or Rcgist. n <br />City License Registration iF <br />****************************************** <br /> <br />ELECTRICTAN <br /> <br />signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration 1~ <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAl. <br /> <br />Signature <br /> <br />Company <br />State Cert. or Rcgist. ff <br />City License Registration n <br /> <br />OTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />~********~*************************** <br />.d AJI"(j . oJ! /I\.,r- , <br /> <br />PERMIT OFFICER. <br />