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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />R e {"{--'Ie f (1 <br />P f"' fr: L-<'-( " I- tL.. <br />d C) //.;;. IS <br /> <br />APPLICANT <br /> <br />/) a, v .- d 1 <br />/'}3/ <br /> <br />j/V/"cit"/~ <br />/ ~ r pt9rr C!~ rot r ) <br />, <br /> <br />)/l/[ d ~ -/. ',.. r J' <br />Wt' ..-It" y (' f.-)Pt".60NE <br />/ / <br /> <br />'77-?-O??~ <br /> <br />ADDRESS <br /> <br />OWNER ,C:; n. ~ e.- <br />JOB LOCATION ~d tJ 7 G ~ / / ft I U C/ LOT SIZE_X <br />LEGAL DESCRIPTION: LOT(S) in of- {; 17 BLOCK d 0> ?SUBDIVISION <br />PARCEL I. D. ~F d / - ~ 6 ~ ~ / (!) c9 / CJ~~~CJ CJ - CJ 06 f} <br /> <br />AREA SQ. FT. <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />____Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____4F of Units <br /> <br />,____M / H <br /> <br />____Commercial <br /> <br />____Indust. <br /> <br />____Swim. Pool <br /> <br />S/a ~ <br />/~ 11~ C) <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 FOR~S.** <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 />6 () <br />/ ':;-3-0 -- Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\\l.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 <br /> <br />____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br /> <br />- CONTRACTOR <br />,,) (J ?t ~I S'v.--z :-/ It. Cr,9I'-'..r;:l; Company <br />~- ----/" ',., ,?? State Cert. or Regist. if <br />,"- - '^ ~l. City License Registration 4F <br />****************************************** <br /> <br /> <br />ELECTRICIAN Company <br />State Cert. or Regist. 4F <br />Shmature City License Registration 1F <br />****************************************** <br /> <br />PLUMBER Company <br />State Cert. or Regist. if <br />Signature City License Registration ;F <br />****************************************** <br /> <br />MECHANICAL Comp&ny <br />State Cert. or Regist. # <br />Signature City License Registration :F <br />****************************************** <br /> <br />OTHER Company <br />State Cert. or Regist. # <br />Signature City License Registration # <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br /> <br />