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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />j. /1' .' /i " <br /> <br />ADDRESS <br /> <br />L ! L/ <br />_..;-t ; <br /> <br />i"j <br /> <br />PHONE <br /> <br />^/t?A/~ <br /> <br />OWNER <br /> <br />v/ <br /> <br />1..1 l <br /> <br />" l-~ <br /> <br />l/ <br /> <br />) I <br />II i, <br /> <br />) <br /> <br />JOB LOCATION <br /> <br />LOT SIZE~X i <br />i L/ - J ~ BLOCK 167 SUBDIVISION <br /> <br />AREA SQ,FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL 1. D. 4t <br /> <br />_Sign/Temp. <br />PROPOSED USE: ~Single Family <br /> <br />_Addition _Alterfl;s-f;;eP4-~d f/n/:;)f/:VJ <br />_Sign _Move _Demol1.sh <br /> <br />WORK PROPOSED:_New Construction <br /> <br />-H./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: 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 f ^,(J PIfI12) <br />Ii e pit;' I . ~ v <br />J,L'BUILDING $ G OO~ 00 Valuation of Total Construction <br />I'f 41 e /l-/ 1/ V <br />_ELECTRICAL AMP Service Florida Power Corp. _____W,R,E,C. <br /> <br />_MECHANICAL $ <br />tW'lt <br />----0"LUMBING I~e".... <br /> <br />_Valuation of Mechanical Installation <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 />Signature <br /> <br />C / <br />...J .' /" / - !--- <br />(~: l ~t.;;! <br /> <br />CONTRACTOR SECTION /"l . / <br />j CompalJ.Y' bO ttHt..../^L/ <br />/ State Cert, or Regist. if <br />YCII i:"f- City License Registration if <br />****************************~************* <br />/' \ , <br /> <br />Company G/:/WnJA/ <br /> <br />State Cert~ or Regist. # <br />City License Registration if <br />****************************************** <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />SilZtlature <br /> <br />Signature <br /> <br /> <br />Company (~/) W-X' pJ <br />State Cert, or Regist. if <br />City License Registration if <br />************************************** <br /> <br />Company <br />State Cert, or Regist. if <br />City License Registration iF <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert, or Regist. if <br />City License Registration if <br /> <br />OTHER <br /> <br />Signature <br /> <br />****************************************** <br />. <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT -DFHCER. ' <br />