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<br />APPLICATION FOR PERI-lIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />ADDRESS <br /> <br />((ilf <br />,53 <br /> <br />?u-r <br />/2 7"'< <br /> <br />'s'y- <br /> <br />PHONE <br /> <br />'7~3 <br /> <br /><8 '1 sO <br /> <br />APPLICANT <br /> <br />OWNER <br /> <br />JOB LOCATION <br /> <br />9~ <br /> <br />LOT SIZE~X /c4 AREA SQ.FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) II <br /> <br />BLOCK .:u::. SUBDIVISION <br /> <br />.:LI <br />, <br /> <br />di1to <br /> <br />01> 7' r'O 019 iJ <br /> <br />PARCEL 1. D. i~ <br /> <br />// <br />( r <br /> <br />. <?~ G> <br /> <br />~! <br /> <br />dOlo <br /> <br />() 'Sfoo <br /> <br />o /9dr1 <br /> <br />~stall <br /> <br />WORK PROPOSED:_New Construct.ion _Addition _Alteration _Repair <br /> _Sign/Temp. _Sign _~love <br />PROPOSED USE: ____Single Family ....:....-M/F _t~ of Units <br /> _Commercial _Indust, _Swim. Pool <br /> <br />_Demolish <br /> <br />, __1'1/ H <br /> <br />Other <br /> <br />BUILDING SIZE: <br /> <br />_Restaurant & Health Department Approval <br />/).- X")-() & FlIt> g lit)) Square Fee t I ~.D <br />, <br /> <br />~-f1/f- <br />I' .. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COM1'IERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FO~~S.** <br />A TT ACH (3) SETS OF BUILDING PLANS & (1) SET EN ERGY FOR~lS. * * <br />**COPY OF CONTRACT REQUIRED. <br /> <br />~F.RMTTS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />if /<DM . iJ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\-l.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 />* *~, **~:*'*** ********** * *~, *;"~~:~, * ,',;, ,', 1, ,', ,', * 1, * 1, <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Rcgist. !I <br />City License Registration 0 <br />****************************************** <br /> <br />77 <br /> <br />Si!!nature <br /> <br />Company <br />State Cert. or Regist. n <br />City License Registration 0 <br />****************************************** <br /> <br />ELECTRTCTAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration 0 <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration 0 <br />****************************************** <br /> <br />MECHANICAT. <br /> <br />Signature <br /> <br />, ' <br />. <br /> <br />Company <br />State Cert. or Regist. 0 <br />City L{~eriS~ ~egistration n <br /> <br />OTHER <br /> <br />,;> , <br /> <br />~" ..l <br /> <br />:{. <br /> <br />r/. <br /> <br />APPLICATION APPROVED BY W;::~";;Jf'~~*:;:;."~"**"""""" <br /> <br />PERl'lIT OFFICER. <br />