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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT ~~cJ~ <br />ADDRESS 3 ?cJL .> <br />6L7o,AJ // <br /> <br />J'i9/7 e <br /> <br />H <br />yr <br /> <br />uJf! rr~C:IZ <br />#v ~ 2-,-9;~ <br /> <br />tt/.4 &:-~ c- ~ <br /> <br />PHONE <br /> <br />7 tf.l'<. ((.' // V <br /> <br />OWNER <br /> <br />JOB LOCATION <br /> <br />LOT SIZE~X/~>ARE.A SQ,FT, <br />BLOCK c; SUBDIVISION y AJ/ ~.L-/~o6S <br /> <br />LEGAL DESCRIPTION: LOT(S) .:2 8-- 2-1 <br /> <br />PARCEL I.D,4~ /2 - U - '2-/ - C.b ~0 - oC'~&(, - 2-J"ZI <br /> <br />WORK PROPOSED:____New Construction. ----Addition ~lteration <br />R e. M.. ve I"" f S'CJl.ePN S <br />____Sign/Temp. . -L-Si,gn ~ <br />I~ $714&L IAI/ Wllv~ w ~ - lV <br />PROPOSED USE: ~Single Family ____M/F ____# of Units <br /> <br />____Repair ____Install <br /> <br />____Move ____Demolish <br /> <br />.~/H <br /> <br />____COlilmerc ial <br /> <br />____Indust. <br /> <br />____Swim. Pool <br /> <br />Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />...::::LBUILDING <br /> <br />$ <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 Installa.tion <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 /> <br />BUILDER <br /> <br />() /)J IU -( IL. <br /> <br />CONTRACTOR ~CTION <br />Company <br />State Cert, or Regist.jf/ <br />city License Registra):1on # <br />****************)~******************~~**** <br />/ / <br />/' / <br />/ Company / <br />/ State Cert. ~Regist. # <br />.' City Licens~ Registration 4~ <br />*******~*****************t4************** <br />/ <br />/ <br />/ <br />Compa9& <br />Stat;..l Cert, or Regist. 4~ <br />~ CU'y License Registration 4; <br />..-* * * * * ** ** *********,*'* *** ** * ** ** * * * * * * * * * * * * <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />Sismature <br /> <br />/ <br /> <br />PLUMBER <br /> <br />/ <br />/~ <br /> <br />Signature <br /> <br />Company <br />State C~rt. or Regist. 4; <br />City License Regis~tation 4; <br />*********************************~~~****** <br />/ <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br />OTHER <br /> <br />4~ <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER, <br />