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<br />APPLICATION FOR PERNIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />~. <br />APPLICANT -1SUt:>6.\:"\ lvv \. ~~\O\.o\..l P.\'. <;'WI..\~\-\ <br />ADDRESS 3~\D Po\\tx.k.. L~~ "2.-~I\lS ~~S\.\l PHONE <:rl'3' 1~- C(5.3b <br />OWNER S,h~1>.t? ~C; ~\ F cn~(j;e- <br />JOB LOCATION ~l,,"'t.\..\\ e:hJI'3- ~~G" DY' 2-l41US LOT SIZE X AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D ,l~ <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 />_l~ 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 Fe'e t, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,** <br />COMMERCIAL: 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 Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />_MECHANICAL <br />LPLUMBING <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />,~",~H~ 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 SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration # <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Sio:nature <br /> <br />Company ~Mk/ /f/f'r!N1t?/</ <br />State Cert. or Regist. # 19q <br />City License Registration iF $'hO <br />****************************************** <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration ff <br />****************************************** <br /> <br />MECHANICAl. <br /> <br />Signature <br /> <br />OTHER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration n <br /> <br />APPLICATION APPROVED BY <br /> <br />~~~~.~;~~~...**..*.*.*. <br /> <br />PERMIT OFFICER. <br />