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<br />cfi) t:::c ~ I o,~ ftv--1 V-.-(:-- e () L l~ <br /> <br />APPLICATION FOR PERMIT @ t::L"=, Dpt'/'\---V-. t3 LO G <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT f/5SOC-/l9-"retJ t:~.c/f( t::;l!?"i!.ulc.c5 ,rVC. CH-I't!f.l.-fE' DG'"A-(... <br />, <br /> <br />ADDRESS e6'1/trRt:'8Vr/E"t-t> t./tIU/S 2/fPII~,eHI(.LS.a. ~354/ PHONE 783- 3~~S <br />, <br /> <br />OWNER D A-U ( 0 ~ tv( ( c H- ELLE ,A-f /1IfT/ NS <br /> <br /> <br />JOB LOCATION 6" OC> 1 ,j--/9--LL (3 L UJ) LOT SIZE_X AREA SQ. FT. <br /> <br />- ~ <br />LEGAL DESCRIPTION: LOT(S) <.0 ( (P A BLOcK-< c t> SUBDIVISION <br /> <br />PARCEL 1. D. ~t <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 />~/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 />/BUILDING <br /> <br />$~~/<j, 30 <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <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 /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist, # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Silmature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Compa.ny <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Signature <br /> <br />S/6-V <br />c4~ ?/. ~ <br /> <br />Company ASs~l'f7e:ZJ lfFaTCi7hCA<- se;ev~ ;rAC. <br />State Cert. or Regist. # ~ooooo ~ <br />City License Registration # 377 <br />" <br /> <br />OTHER <br /> <br />~***********;!************************** <br />APPLICATION APPROVED BY ~ (]- J~ LA,,~ <br /> <br />PERMIT OFFICER. <br />