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<br />APPLICATION FOR PE~lIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />JOB LOCATION <br /> <br />1Jir? -I12i1e ,-<5 [ ( 6 V.]) <br />, , , ~ f. <br /> <br />(;, I d- r':) rf?-2 ~ 1/. <br />~a.-f6J\ :;7J2-~ D1~ ~ ~~ ~ <br />S#J71Ll <br /> <br />-~,~ <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />~"> ~;.--~ Q <f; <br />X \ ( f) <br /> <br />OWNER <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 /> <br />WORK PROPOSED:____New Construction ~Addition ____Alteration ____Repair ____Install <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 />____# of Units <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 />PERMITS REOUESTED <br /> <br />ABUILDING <br />____ELECTRICAL <br /> <br />$ <br /> <br />bOO <br /> <br />Valuation of Total Construction <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 <br /> <br />____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />CONTRACTOR SECT~.. f) / n '/7/J - (Ir.J) '"--IJr 0 <br />BUILDER Company _~ Gz.Y.-?~? ~ <br />S1' gnature C1,Aq.~? <::)/ ?12t~~ State Cert. or Regist. iF <br />Iru..r~ [ft, ~J!.J.. City License Registration # .;;t...< Y. <br />****************************************** <br /> <br />Sie:nature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />ELECTRICTAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <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 />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />~.** *********~************************ <br />.' 'c14tA'a d~/L.,r- <br /> <br />PERMIT OFFICER. <br />