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<br />/ <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT J 1"T-n-1 ts:' /Yl f<-EZ j k c <br />ADDRESS "3 7 }o V t.-J J"f-Ve-P L V <br />OWNER T ~ 1-\ /J? I/~'):::.t:- <br />JOB LOCATION 5 ;:210 / 9 ~ ~T; <br /> <br />/ft/'~ <br /> <br />PHONE <br /> <br />733 <br /> <br />7 ,). I L/ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />LOT SIZE_X <br />BLOCK X SUBDIVISION <br /> <br />AREA SQ.FT, <br /> <br />PARCEL 1. D, # <br /> <br />, <br /> <br />I ~, sr~t>f\ <br />____Install ~~ <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ~Repair <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 of Uni 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 />~ILDING <br /> <br />PERMITS REOUESTED <br /> <br />~ <br />$ /023'1- <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\';,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 <br /> <br />____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 />ELECTRTCIAN <br /> <br />Company <br />State Cert, or Regist, # <br />City License Registration # <br />****************************************** <br /> <br />Signature <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 /> <br />QIHEE ' R Ct /c) ,'Y1/J <br /> <br />, '-j <br />Signature- , <br />,-, <br /> <br />?~(jC~ <br /> <br />Company <br />~tate Cert. or Regist. 4ft <br />City License Registration # <br /> <br />APPLICATION APPROVED BY <br /> <br /> <br />PERMIT OFFICER, <br />