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<br />APPLICATION FOR PERl-lIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER <br /> <br />3#~C/ PA)& '~C- <br />/ 1 ~ ~ . ). ,.d';;~.? / <br />/';; IV · nz,u y::sro <br />13~fA-N If ~ ,JlHA-fA <br /> <br />JOB LOCATION S-r;~ ~ sliL j7 LOT SIZE <br /> <br />LEGAL DESCRIPTION: LOT(S~' / 3>-/4-- IS- BLOCK q I SUBDIVISION <br />PARCEL I.D.~~ I J - L,&' - 'j( ~'OOIC> - 0 q I tJ () - 0 I 30 <br /> <br />PHONE ft7-)~f2- <br />I-I~to'" <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />x <br /> <br />AREA SQ.FT. <br /> <br />- ~?D ZII <br /> <br />WORK PROPOSED:____New Construction ~Addition ~Alterntion ____Repair ____Install <br /> <br />____Sign/Temp. <br />PROPOSED USE: ~Single Family <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Demolish <br /> <br />,,:,,-M/F <br /> <br />____~~ of Uni ts <br /> <br />,._H/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: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORNS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />V <br />_BUILDING <br />V <br />____ELECTRICAL <br /> <br />~ECHANICAL <br /> <br />$ <br /> <br />valuation of Total Construction <br />~Florida Power Corp. <br /> <br />_H.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />,.t#'.. . <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 />~ONTRACTOR SECT~ 1'1' {b .J-~- <br />. Company ~ y y-e--v <br />State Cert. or Regist. il C19~-O/O?,2jJ <br />City License Regi;tration il /5- <br />******************************** <br /> <br /> <br />Signature <br /> <br />:!:::~:d ~. Company (J(I/l'i?Eht'd< 56/-di:G" <br />...~ . Tn /1 /I S~ate ~ert. or R<:gist. . il OcJ/.a/~/ <br />_1______ _ . ~ C1ty L1cense Rer;1.str:J.t1on il 6lLJ~ <br />- . .. ~...........................*..*;...,.*". <br /> <br />PI,tJMBE~~~~ company..s TEVt?~.S' ~t:. ~L'/"7 -61' "c/y <br />State Cert. or Rcgist. !.f I!. rOo ~~Yb~ <br />Signature City License Registr:J.tion il / / S- <br /> <br />MEeHANI"A! ~ . I/~:;~"""':::::::'~::::~;:~~~~/.f;et~~-cr <br /> <br />?7 ~ ~ State Cert. orl7ecist. Ii &ma7/J'~/ <br />Signature . City License Registration i.~ ;l <br />****************************************** <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration 1 <br /> <br />OTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />~********~*************************** <br />.aAA~(j ~ €I\ ~ . <br /> <br />PERl-lIT OFFICER. <br />