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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />~~~~- 1, HI ~~~ <br /> <br />OWNER <br /> <br />4- '7 ,S"'f <br />.3ot-v\~ <br /> <br />v0 ~ ~ /1-' r'r~/~/ .ti:jr;(r <br />-" L"J U t ~L"1 <br />t, n-- ~ F.to , 1> ~ ~!:! PHONE <br /> <br />ADDRESS <br /> <br />JOB LOCATION ..,s.c:;, UA e.- <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />LOT SIZE <br /> <br />x <br /> <br />AREA SQ,FT, <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, ____Sign ____Move ____Demolish <br /> <br />____Commercial <br /> <br />____Indust, <br /> <br />____4~ of Units _____M/H <br />_Swim. Pool ~lhk r~ Other <br /> <br />PROPOSED USE: ____Single Family <br /> <br />_M/F <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 Set'vice <br /> <br />Florida Power Corp, <br /> <br />_W,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 _Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER ~(-1P (- <br />Signature <br /> <br />SiQnature <br /> <br />Company <br />State Cert, or Regist, # <br />City License Registration # <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />PLlJMRER <br /> <br />Signature <br /> <br />Company <br />State Cert, or Regist, # <br />City License Registration iF <br />****************************************** <br /> <br />MECHANICAL <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 />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />