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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER <br /> <br />~'1V5-{ ; Ca~i~ <br />? <br />7' ? c7~ /7 ~,-vO <br />Ii I) ~ Or .( Fr f"L ( <br /> <br />. <br /> <br />PHONE <br /> <br />? 8,<- ~.?&-o <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />JOB LOCATION ,~~ Y 7 <br /> <br />5 "6'5r/" <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 1. D, ~,~ <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install <br /> <br />____Sign/Temp, <br /> <br />____Sign <br /> <br />_Hove <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />_M/F <br /> <br />____# of Units <br /> <br />,_H/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 FOR..'1S. ** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORt-IS, 1", <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />$ <br /> <br />AHP Service <br />/17S-:~ <br /> <br />Florida Power Corp. <br /> <br />_h',R,E.C. <br /> <br />____ELECTRICAL <br /> <br />____HECHANICAL <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 />BUILDER Company <br />State Cert, or Regist. # <br />Signature City License Registration if <br /> <br /> <br />:::::~. (~t;"'''''''''::::::-;;::~';*(?~'~''{frJ' . - . <br /> <br />. " ' S~ate ?ert. or R:gis t, . l.frleOo i I 5 1'1 <br />______ _ Cl.ty Ll.cense Regl.stratl.on iF /SC{ <br />****************************************** <br /> <br />Company <br />State Cert, or Regist, # <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br />Company f0 /I, < ~ v C "- ~....~ <br />State Cert, or Re1fist. ;, I? ~?OSb'b8' <br />City License Registration 'F ? / <br /> <br />'-. <br /> <br />Company <br />State Cert, or Regist. # <br />____ City License Registration # <br /> <br />*::,~ "'IlW>"f<>...f~. I <br />,;'. #-4'!-p-<---' ". '/ PERHIT OFFICER. <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />