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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHtRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />.~ ' <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />f.-i /J, .-c: IJ ) <br />OWNER / ) LmtD \,V....-IZ2AAt(,.('bJV <br />JOB LOCATION S /~-I ';?t.;}-i'J l~ <br />LEGAL DESCRIPTION: LOT(S) ~ BLOCK <br /> <br />LOT SIZE X <br /> <br />AREA SQ. FT. <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.,~ <br /> <br />WORK PROPOSED:____New Construction ----Addition ----Alteration ____Repair ____Install <br /> <br />____S~\,gn/Temp . <br /> <br />__Sign <br /> <br />_Move <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 />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 />~UILDING <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.C. <br /> <br />____MECHANICAL <br /> <br />$ <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 />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />",.."-, <br />/ I ' <br />BUILDEUj tJfi..LA ) <br /> <br />Signature <br /> <br />Si(ffiature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />ELECTRTCTAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />PLtJMRER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City l.icense Registration 4~ <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br /> <br />PERMIT OFFICER. <br />