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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER <br /> <br />7l/db~ a~J (~/}Jj <br />6o"f~ /7Pl P <br />./ <br /> <br />~ l1"- ~~~ /~ 7V1L/~A- <br />S/tmL <br /> <br />?IMP '/--L/L__ <br />PHONE ~/?'- 7P-.3- $/3 <br />~L::t:::t- $A-. <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />JOB LOCATION <br /> <br />LOT SIZE <br /> <br />x <br /> <br />AREA SQ. FT. <br /> <br />'. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.4F <br /> <br />WORK PROPOSED:_New Construction ----Addition ----Alteration ----Repair _Install <br /> <br />_sign/Temp. <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Demolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />_M/F <br /> <br />_4F ofUni ts <br /> <br />__M/H <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />_PLUMBING <br /> <br />.~ <br /> <br />_V~ation of Mechanical Installation <br />~ROOFING SPECIALTY <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />GAS <br /> <br />TYPE OF CONSTRUCTION: _Block _Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br /> <br />****************************************** <br />CONTRACTOR SECTION;) " (' f <br />Company -Trt1Y),C-r ~:oC6 <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br /> <br />-- <br />he. <br /> <br />SilZnature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />ELECTRTCTAN <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 />MECHANTCAT. <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />** <br /> <br /> <br />PERMIT OFFICER. <br /> <br />"'-;,:~~~!e~~tJ#'TPrVED <br /> <br />,~; -~;' V: : ".; F~~'~-I <br /> <br />~~":jlM""""""lI'~':'~-"""'~""""'" -'.~ f....,:, .",...-1" <br /> <br />, <br />BY ! <br /> <br />