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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />ADDRESS <br /> <br />--1De <br />5<3 ~~ <br /> <br />y mRS JEsTeR. <br />\ $t Stve G~ <br /> <br />PHONE~ '6'0 -- lP~zi <br /> <br />APPLICANT <br /> <br />OWNER <br /> <br />5'A1YL:t=" , <br /> <br />JOB LOCATION <br /> <br />0AY1e' <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. # <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration <br /> <br />-.L'Repair <br /> <br />____Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />_~ove <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____# of Units <br /> <br />____M/H <br /> <br />____Commercial <br /> <br />____Indust. <br /> <br />____Swim. Pool <br /> <br />Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />CmlMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR.'1S. ,~* <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~S.** <br />,'dreOpy OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_w.R.E.e. <br /> <br />____PLUMBING <br /> <br />GAS <br /> <br />Valuation of Mechanical Installation <br /> <br />/' ROOFING SPECIALTY <br /> <br />____MECHANICAL <br /> <br />$ <br /> <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />CONTRACTORS <br />Builder <br /> <br />Company <br /> <br />Signature City License Registration # <br />************************************************************************.~**************** <br /> <br />Electrician <br /> <br />Company <br /> <br />Signature <br /> <br />City License Registration # <br /> <br />***************************************************************************************** <br /> <br />Plumber <br /> <br />Company <br /> <br />Signature <br /> <br />***************************************************************************************** <br /> <br />City License Registration ff <br /> <br />Mechanical <br /> <br />Company <br /> <br />Signature City License Registration if <br /> <br />~;~:;****.**..****..*****.*********.****.*~:;;::~~~;:;***~:~~~~f*'~)~~:~~';:~~( <br /> <br />Signature ~ cf ?~ City L,cense Registration j, ~ <br />7 <br />I Hereby certify t,hat I have read and examined this application and know the same to be <br />true and correct. All provisions of law and ordinances governing this type of work will be <br />complied with whether specified herein or not, the granting of a permit does not presume to <br />give authority to violate or cancel the provisions f any other state or local law <br />regulat' g cons or performance of constr n. <br /> <br />~iYnJe <br /> <br /> <br />Sign~ture of 0 <br /> <br /> <br />_1- 2JJ 'CfZ-- Date <br /> <br />~~:t~-I <br /> <br />I - 2D-A 2-> Da te <br />signed by the owner and notarized. <br />