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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />j) .i ( Co~_A-QA-<:...-+oe. <; <br />ADDRESS S 7 0 8 ?:!..!::::- 5-1-... <br />OWNER ~ "Lm_ (;rI~;~ <br /> <br />JOB LOCATION 'f,f-;;.;).. -~ <br /> <br />~-0( <br />2-1.; 1I( <br /> <br />PHONE <br /> <br />',0 <br />07 <br /> <br />Q/S''1 <br /> <br />APPLICANT <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.iF <br /> <br />~/ <br />____Repair <br /> <br />_Ins tall <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration <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 />____iF 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 FORt'1S. H <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />V <br />_BUILDING <br /> <br />$ --S- Cr7J . cr0 <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_H.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 SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration 4F <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 4F <br />City License Registration 4F <br />****************************************** <br /> <br />ELECTRICIAN <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 4F <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY ~.;:::;:~..~:;:;::~..*.*.**.*...* <br /> <br />A C () M /111 j ICCAL GtfEC K.. ,.:5 <br /> <br />PERMIT OFFICER. <br /> <br />KEG. <br />