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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />SC/ ~ E? ,,?/~ 0 /~ <br />, <br /> <br />~c/'7,';":J ~~,/ aO/N..J /ry~ _~/c. <br />S~ #4-/0 o/61,y/~,.fa IN'''--?HONE 8.s-y - ~Y'P"9 <br />~/<"".:t./ S'. /f'/' <br />57! .2riK.LA" M' LOT SIZE <br /> <br />x <br /> <br />AREA SQ. FT. <br /> <br />ADDRESS ;;1 ~ / a,?(<./ h 5 <br />;/ <br />OWNERS'7:.? "..y4/ <br />/. <br />JOB LOCATION ti//t::? /0"' 7;.( <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. # <br /> <br />WORK PROPOSED:____New Construction ----Addition ----Alteration ~Repair ____Install <br /> <br />____Sign/Temp. <br /> <br />____S ign <br /> <br />_Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />_M/F <br /> <br />____41 of Units <br /> <br />.-M/H <br /> <br />____Commercial <br /> <br />_Indust. <br /> <br />____Swim. Pool ~ C'X(wyca70ther <br />7'- ~;c:7?1 c:l'A.:.Jt' ~)4)7'~ <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 />~ECHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />$ <br /> <br />~ f'oa <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. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Silnlature <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 />PLUMBER <br /> <br />Signature <br /> <br />MECHANICAL <br />Signature k-4J/ a: <br /> <br />Company ..5Z'/I~~/c..<" #./,r;.;""i' ""':c-<~;"9 #Jtj/'_Z;;c <br />.. r./ -. .- <br />. State Cert. or Regist. 4t c-f,CO-,?,rt?7/ <br />c.U~ City License Registration 4~ <br />. *~*******'******************************** <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />~*********~************************** <br />~ -f" ~ o../j./. ^'^ -;- <br /> <br />PERMIT OFFICER. <br />