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<br />APPLICATION FOR PER~IT <br />CITY OF ZEPHYRHILLS <br />BCILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />((iN ~~- C~.~h 4 <br />/' <br />7 7 ;2 Z F';: /~'-~ <br />..--- <br />Ca. Y II ( / t!'l.,t',..A.,- <br />Q <br />r /3 Cf 2.. 0 /1/ /Iv A... <br />. <br /> <br />PHONE <br /> <br />fB/r- "./8;2-';< 7" c> <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />JOB LOCATION <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 I.D.# <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 />_~~ of Uni ts <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 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 />Valuation of Total Construction <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />AMP Service <br />atJ <br />~gz? <br /> <br />Florida Power Corp. <br /> <br />_H.R.E.C. <br /> <br />_ELECTRICAL <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 />Signature <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration iF <br />****************************************** <br /> <br />BUILDER <br /> <br />ELECTRTCTAN <br /> <br />Company <br />State Cert. or Regist. iF <br />City License Registration iF <br />****************************************** <br /> <br />Sil?nature <br /> <br />Signature <br /> <br />Company <br />State Cert, or Regist. ;ft <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br /> <br />,/.. <br />Comp~r..y /' ( '" s. -eJ <br />S ta te Cert. or Regi's t. ~,! <br />City License Registration # <br />****************************************** <br /> <br />c ~/'-R <br />/</ftS- erO? 0 <br />7/ <br /> <br />MECHANICAL <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration iF <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br /> <br />PERMIT OFFICER. <br />