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<br />APPLICATION FOR PERNIT <br />CITY OF ZEPHYRHILLS <br />I ~ILDING DEPARTMENT <br /> <br />APPLICANT !1., wAtf f) 1/ /1 ~ 7) fit <br />b 1~):3 J>E/!;RL ,-S / . <br /> <br />, <br /> <br />S h # E': <br /> <br />...- <br />c.;~ 7 r-- <br />JOB LOCATION L---' L./ ff~ c- <br /> <br />I ' <br />PHONE 7 g g - f' ~ 9 0 <br /> <br />ADDRESS <br /> <br />OWNER L--. <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br />-::2../- 6--0 <br /> <br />SUBDIVISION <br /> <br />PARCEL I,D,# <br /> <br />;]-r:l6 <br /> <br />WORK PROPOSED:____New Construction ----Addition <br /> <br />~/ <br />____Alteration <br /> <br />____Repair ____Install <br /> <br />____sign/Temp, ____Sign <br />PROPOSED USE: ~ngle Family ____M/F <br /> <br />____Move ____Demolish <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) PLOr PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOID-lS.'~* <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />V;UILDING <br /> <br />$ ~5'OOt oCJ <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\'V.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 /> <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />SiQnature <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />ELECTRTCIAN <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # - <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cprt. or Regist. ~ <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />OTHER ~ <br /> <br />Signatur~;/'~ Jdd d...4L <br />~,.;;;:;~..~~~~~...*....*******..** <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration iF <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />