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<br />APPLICATION FOR PE~~IT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />o,jAO<lte $ (iLl f-CL I ~ 1 <br />'3 r / I 3, ( ( -ii ;J-,; <- <br />-.\tt-r>HO' S (~ffl;AJ.L <br /> <br />PHONE 7J?r;- - C -:s 1-1, <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />JOB LOCATION 3 t 1'-1 :< tt1tn--d flJ e.- <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I,D,4~ <br /> <br />WORK PROPOSED:____New Construction ____Addition ----Alteration ~Repair ____Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />____Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____# 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 Feet, <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 FORMS.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 />____MECHANICAL <br /> <br />$ <br /> <br />AMP Service <br />~ c) ,) <br />/:. -/J r- ~<- <br />j f./ ..;/ . <br /> <br />Florida Power Corp. <br /> <br />_W.R,E.C. <br /> <br />Valuation of Mechanical Installation <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 />****************************************** <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />ELECTRTCIAN <br /> <br />\<. <br />\2. <br /> <br />~ . ~ <br />\d u ~ F \ ~ \.. \) Company 7- Ili/L.;; Ekc'7 je'<../ <br />C~\ ;::~ State Cert. or Regist. # t't.'LJ.:;2/&.R <br /><--" t::J/ City License Registration l~ /0 <br />****** * ************* * *** ** ** *.,d,." ** * * * * * <br /> <br />Signature <br /> <br />PLUMBER <br /> <br />Company <br />State Cert, or Regist, # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />Signature <br />// <br /> <br /> <br />Company # /' h y;,e d..e7 <br />State Cert. or R~gist. #'/1LY'~L)~?;l[' <br />City License Registration 4F uh& <br />*********************************** <br /> <br />OTliER <br /> <br />Signat.1re <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />APPLICATION APPROVED BY <br /> <br /> <br />PERMIT OFFICER. <br />