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<br />APPLICATION FOR PER~IT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />ADDRESS 5[50 ~ If) Tk. <)) <br />() I '1 rfi" I <br />OWNER ~l'\v.v r ~ :\ .(v\\.l~'\\o<)\'" <br /> <br />JOB LOCATION S<103 III ft\ sf <br /> <br />PHONE'~ ..55.3 () <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. # 11-.;2.6 ,~,;2.- i ~ 0 C1 Ie) -- cJ 7..2 C7cJ r- c?CJ -9C? <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 & 0) SET ENERGY FORMS.u <br />**COPY OF CONTRACT REQUIRED, <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br />LELECTRICAL <br /> <br />$ <br /> <br />ICD <br /> <br />AMP Service <br /> <br />Valuation of Total Construction <br /> <br />~lorida 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. ff <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />t ~ F~ .~ Y <br />A ~ :.- eCompany c (? .?-- C' ~,~ <br /> <br />:::::::: ~ ~~.- :....*....m~:~m~~: :;:;m;:~~;~ ";; 'j~,y 6 "''' <br /> <br />Company <br />State Cert. or Regist. ff <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 />~*********. ******************************* <br />APPLICATION APPROVED BY ~(J- .::,f/~~ PERMIT OFFICER. <br />