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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT f?O~~f S SrC;f\ ~pO--+ IV\C <br />/0 I Deot IF (A-ue fS!'OoIc!::'v,I/<:: I FL <br />, <br /> <br />JohV\..::,oV\. er.;e' ,1\s,'L'i ~-\--e <br />JOB LOCATION ::3 '30 ~'G 1U01't'r-... Aue <br /> <br />PHONE <br /> <br />90Y'-719-/9.:J_~ <br /> <br />ADDRESS <br /> <br />OWNER <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.ifF <br /> <br />'/~C)b -;;)I-OQIO-ODg'OO- OdbO <br /> <br />_Sign/Temp. <br /> <br />_Addition <br />ASign <br /> <br />_Alteration <br /> <br />_Repair <br /> <br />_Install <br /> <br />WORK PROPOSED:_New Construction <br /> <br />_Move <br /> <br />_Demolish <br /> <br />PROPOSED USE: _Single Family <br />~commer~ial <br /> <br />_M/F <br /> <br />_ifF of Units <br /> <br />._M/H <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 FOR~S.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.*~' <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />L/!j7o~ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\-I.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 _Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />Signature <br /> <br />IU..:I /: <br /> <br />CONTRACTOR SECTION () . '-l -,....., <br />Company ~O r:l' r S S ~ I'\. [)~ r .J.. II C <br />/J State Cert. or Regist. # R)t.." 06;:>0"3'5 <br />,I:C-e-~ City License Registration IF 5''6 ~ <br />~****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration IF <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration ~ <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />**~*****.*~~************************ <br />~ vA A'Jvr"J <br /> <br />PERMIT OFFICER. <br />