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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />....., <br /> <br />APPLICANT <br /> <br />E"A.> If I ~.0M ~i A '-- (\ f'.1l.3r'ROO:::r-o 'R. S <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />OWNER <br /> <br />~c~ D M~A X\DJU <br />JOB LOCATION 5~ q~ 5T <br />J 3 J JV <br />: <br /> <br />4,0 )) <br /> <br />ALAN ~oJ\lSD~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />LOT SIZE_X AREA SQ. FT. <br />BLOCK lie; SUBDIVISION QI'l e)F 2E..~ \\ IfF:. HILLS <br /> <br />PARCEL 1. D. # <br /> <br />HORK PROPOSED:____New Construction _---Addition ____Alteration ____Repair ~Install <br /> <br />____Sign/Temp, <br /> <br />_Sign <br /> <br />_~ove <br /> <br />_Demolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />---.J1/ F <br /> <br />____ft 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 FORNS.** <br />**COpy OF CONTRACT REQUIRED, <br /> <br />PKRHITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E,C. <br /> <br />-HECHANICAL <br /> <br />$ 6rkJ.~ 00 <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: <br /> <br />FT, <br /> <br />CONTRACTORS <br />Builder <br /> <br />Company <br /> <br />Signature City License Registration # <br />***************************************************************************************** <br />Electrician . Company t,Jff?NJII-,:J Stt~I~;}'\ So <br /> <br />Signature City License Registration # <br />********************************** ****************************************************** <br /> <br /> <br />Plumber <br /> <br />Company <br /> <br />Signature City License Registration # <br />***************************************************************************************** <br />Mechanical Company ~~..)\:tRoiOM~'iAL OW~\o~.s. <br /> <br />Signature City License Registration # <br />*********************~~********** ******************************************************* <br /> <br /> <br />Other <br /> <br />Company <br /> <br />Signature <br /> <br />City License Registration # <br /> <br />I Hereby certify that I have read and examined this application and know the same to be <br />true and correct. All provisions of law and ordinances governing this type of work will be <br />complied with whether specified herein or not,' the granting of a permit does not presume to <br />give authority to violate or cancel the provisions of any other state or local law <br />regulating construction or performance of construction. <br /> <br />'\~ (3~ <br /> <br />tf Sign~~ture of Owner <br /> <br />/1-:1.9-0,1 <br /> <br />\"",' .111 11"1// <br />Signature of contrac~~~~~....e~:;/-:~-:;. <br />~O~..... .....</~ <br />D ~ I ,~~ <br />ate 5<'f \"1 <br />. &- g +\ * J :t-.~igned <br /> <br />/tJ DT,l/p,/ - ()~L~ ~,~~~...............<~jf <br />U ~/' I [ 0 f . \ 'Z\ ,.;.' <br />CDPI/I)IS5t: rJ 1/ I;Jf / 9S '1//II;'It/f:r';l\~;\\":"\~:'u_- <br />E :x(JIRJ;:~ fI JANiS R. CJ/I.,i <br />_ _._ Cvn Nov. 14. 199il <br /> <br />Date <br />by the O\vner <br /> <br />and notarized. <br />