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<br />APPLICATION FOR PE~lIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT ;)lA.AU.~ f.~l? . <br />ADDRESS ) /3/ b Jl f;; 4. d;I. ~ <br />OWNER 04->~ "" . ~LI ~I..,./rt Y- <br />JOB LOCATION !. ~- / cZ )>(.0/ J ./ /? L../LOT <br /> <br />/ PHONE <br /> <br />SIZE_____~ AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.# <br /> <br />d- -;}t -d-./ -/4 - 0 <br /> <br />/ <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 FO~~S.** <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 />~~ECHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_____\-l.R.E.C. <br /> <br />$ <br /> <br />3~()O <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 />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />ELECTRTCTAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />PUJMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />Company ~I v-t-<-<1..-d.Av1...- ,A/Y.../h, {# <br />;:;z./ ~ State Cert. or Regist. if CH /' .:l.:9 <br />~ 4-. . City License Registration!F /cJ5 <br />/ . ***** ************************************ <br /> <br />y / ..3 :J- <br /> <br />MECHANICAl <br /> <br />OTHER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />APPLICATIDN APPROVED BY <br /> <br />~************************************** <br />r-L11Q ..>f!j. 0/1 A~ <br /> <br />PER.~IT OFFICER. <br />