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<br />APPLICATION FOR PER~IT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />Qaqfdtr I ~ LG-Cmt C- <br /> <br />7 J t.j €. l4-ou./1t-t"UO A-lle- Oil-OC: C, r Y PHONE ~ 21 ~. ro ~ z r <br />-15m tV4-tfo.J c! K~uIJ QUIlN(," <br /> <br />JOB LOCATION 6'QJQ 02o.H 'ST. LOT SIZE_X AREA SQ.FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) ifr} 111JIif' BLOCK '-1<\ -SUBDIVISION PiA,8cok I P't.c Y <br />() ~ Ifilli'd f- u r 3 ~ EA>r ff/ttr d F (tJf 'f <br />PARCEL I.D.4F 1/ '~;;'.l~ - 2/-60 to -d yJ-OO ~ tJo (l{) <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />WORK PROPOSED:____New Construction _Addition _Alteration ____Repair ____Ins tall <br /> _Sign/Temp. _Sign _Move ____Demolish <br />PROPOSED USE: _Single Family _M/F Z 4F of Units ____M/H <br /> _Commercial _Indust. _Swim. Pool Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~S,** <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />**COPY OF CONTRACT REQUIRED, <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br />-i-ELECTRICAL <br />____MECHANICAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />AMP Service :>\ Florida Power Corp. <br /> <br />_\~.R,E.C. <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 /> <br />CONTRACTOR SECTION <br />BUILDER Company <br />State Cert. or Regist. # <br />Signature City License Registration # <br /> <br />A~ . I ~~~~;:"*""::::::~~;;*;'*E;fCmC <br />::::::::: ~ ~ ~**....******..***m~:~~m~; :~=;;;;;~~ ;;~ 7tZ ~~/,2 Z? 'j <br /> <br />PLUMBER <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br /> <br />Company <br />State Cert, or Regist. # <br />City Lice ~egistration <br />j <br />'7"~.. <br /> <br />OTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />