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<br />APPLICATION FOR PE~IIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT Lla2.hJ ~6-lk rote ?riuru-'flp ~ <br />ADDRESS 600(0 ANOfAz..~()~1<o 'TAMPA, FL. 3~0 ~Lf <br /> <br />I <br /> <br />OWNER K~5(4~>e JIVC. <br />JOB LOCATION ~~~ ~~8 \(~tvtfrn(~ 6t.-D~. <br /> <br />PHONE (. 613) f?g~ -77</-1 <br /> <br />LOT SIZE_X <br /> <br />AREA SQ,FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 1. D, ~F '- -q - d.. 6 - a / <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED:____New Construction ____Addition <br /> <br />XAlteration <br /> <br />____Repair <br /> <br />_Install <br /> <br />____Sign/Temp. <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Demolish <br /> <br />PROPOSED USE: _Single Family <br />Xcommercial <br /> <br />_H/F <br /> <br />_~F of Uni ts <br /> <br />__M/H <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 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 />LMECHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\~.R,E.C. <br /> <br />$ '3.100.00 <br />I <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br />~ )(171'1 NC'}---.O ther <br /> <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />_Frame _Steel <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 />Si~ature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />PLlJMRER <br /> <br />Signature <br /> <br />Signature <br /> <br />Company (! 'fZl !JN~lL h ~ l2. ?QDTI~-C-rlO J <br />(JJ ~/I- \ S~ate ?ert. or R~gist. ,1.' ~~ " 00 7 <br />~ liWAi:G C1ty L1cense Reg1strat1on ~F <br />** ************************************** <br /> <br /> <br />MECHANICAL <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPFOVED BY <br /> <br />~**********~!************************ <br />~ _ ..v\AJ"Vt ,....- <br /> <br />PERMIT OFFICER. <br />