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<br />APPLICATION FOR PERtlIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT CJl~f \; hAl//( <br />-37 ,s-2>' ,/It cvet.{ 's <br />()/ lie e J... 1;/( <br />JOB LOCATION S' 569 <br /> <br />OWNER <br /> <br />13(( f19 r> <br />'L Y k~ x S <br />slit J3t- <br /> <br />~ <br /> <br />PHONE <br /> <br />. 7~').. - ~ 5 :z t.; <br /> <br />ADDRESS <br /> <br />" <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 I,D,# <br />WORK PROPOSED:_New Construction ____Addition ____Alteration ~Repair ____Install <br /> <br />_Sign/Temp. <br /> <br />____Sign <br /> <br />_Nove <br /> <br />____Demolish <br /> <br />____Commercial <br /> <br />____Indust, <br /> <br />____~~ of Units ,.____M/H <br />____Swim., Pool :)ewe^- ,(efl{Pc€~ofl( <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 />____BUILDING <br /> <br />$ <br /> <br />Valuation of Total <br /> <br />jL-uP-J '7' ~ -t-" <br />, . ..--,~ J ~ ~1fI9+ <br /> <br />Construction ..t) l' <br /> <br />PERMITS RF.OUESTED <br /> <br />____ELECTRICAL <br /> <br />AMP Service <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, n <br />City License Registration n <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Sionature <br /> <br />Company <br />State Cert, or Regist, n <br />City License Registration n <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Signature <br /> <br />. Company. (' ~1/<; I3~JI~ ~~*6 <br /> <br />~._ ~)) /.502 State Cert. or Regist. II _. F. - - 1- .. <br />~a . City License Registration n ,57 <br />****************************************** <br /> <br />PLUMBER <br /> <br />Company <br />State Cert, or Regist. n <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAl. <br /> <br />Signature <br /> <br />Company <br />State Cert, or Regist. ff <br />City License Registration # <br /> <br />..------... " j <br />/ i ./ . ..... <br /> <br />~*~~jJ~***-~t:J~;;;~~:L<~***** PERMIT OFFICER, <br /> <br />- , <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br />