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<br />:,t ':.1.:,1,'.. <br />APPLICfATXON FOR PERNI:T <br /> <br />CITY OF ZEPHYRHILLS <br /> <br />BUILDING DEPARTHENT <br /> <br />APPLICANT <br /> <br />Gordon Ten Brink <br /> <br />;; 'I). . <br />'~ ' "~~' ~:. . . <br /> <br />..:. <br /> <br />ADDRESS <br /> <br />35512 Chester Dr'ive, Ze:i>:n:y;rhillSo' FL <br /> <br />PH0NE <br /> <br />782-9138 <br /> <br />OWNER <br /> <br />Skydive City, IHc~ <br /> <br />. '. ,:.t . :'~~':'l. j <br /> <br />.... <br /> <br />JOB LOCATION Skydi ve Ci tv Jump site <br /> <br />, , <br /> <br />LOT SIZE400 X ROO AREA SQ.FT. 1?0000 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.1i <br /> <br />Sec. 18, Twp. 26S/,Rng. 22.E. <br /> <br />WORK PROPOSED:_Nc\v Construction _Addition ~Alteration _Repair _Install <br /> <br /> _Sign/Temp. ----,:Sign - Nove _Demolish <br />PROPOSED USE: ~Single Family ~/F ~fj of Units ,._H/H <br /> -="::':":':'Commercial ~Indust, _Swim. , Pool Canopy Other <br /> <br />_Restaurant & Health. Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Fcc t I <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORl-IS.** <br />COH2-1ERCIAL: ATTACH (3) SETS. OF BUILDING PLANS & (1) SET ENERGY FORNS. *j, <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PF.RMITS REQUESTED <br /> <br />~BUILDING <br /> <br />$ <br /> <br />200.00 <br /> <br />. Valuation of Total Construction <br /> <br />. ..... . ,. <br /> <br />_ELECTRICAL <br /> <br />AHP Service . <br /> <br />Florida Power Corp. <br /> <br />_H.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />~ <br />.' <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br />.. <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_Frame _Steel <br /> <br />x <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT.' <br /> <br />****************************************** <br /> <br /> <br />. CONTRACTOR SF.CTION <br />Company <br />State Cert. or Rcgist. Ii e,.c, c.. <br />City License Registration 0 <br />****************************************** <br /> <br />o S<l Yz.-Z <br />//0 <br /> <br />ELECTRTCTAN <br /> <br />Company <br />State Cert. or Rccist. n <br />City License Registration U <br />***~************************************** <br /> <br />Si!?'nature <br /> <br />'PI.\JMBER <br /> <br />Company . <br />. State Cert. or Regist. il <br />City License Registration 0 <br />****************************************** <br /> <br />Signature <br /> <br />HECHANTCAL <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration U <br />****************************************** <br /> <br />Signature <br /> <br />OTHER <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration Ii <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED TIY <br /> <br />PERl-lIT OFFICER. <br />