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<br />APPLICATION FOR PER!'lIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />v--of\ (cl <br />ADDRESS )0 ooJ rr,ora..R)~ yjf.iJCj~ (101 <br />J <br /> <br />L ; 17 /J.. <br />)17/1 57 <br /> <br />fh:JF <br /> <br />APPLICANT <br /> <br />PHONE <br /> <br />710 - I,/]L/ <br /> <br />OWNER -r lieD OCJAe <br />c"'- -, 7 <br />JOB LOCATION oJ C1 0{ <br /> <br />LOT SIZE_X <br /> <br />AREA SQ,FT. <br /> <br />~~oo <br />;X~f1 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. If <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration Repair _Install <br /> _Sign/Temp. _Sign _Move _Demolish <br />PROPOSED USE: bingle Family _M/F _IF of Units __M / H <br /> _Commercial _Indust. _Swim. Pool Other <br /> <br />, <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUJLDING 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.'1S. ,,,', <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.*~ <br />**COPY OF CONTRACT REQUIRED. <br /> <br />_BUILDING <br /> <br />$ <br /> <br />y?i'7s ~ <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />'.t <br />_MECHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.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 <br /> <br />_Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />Signature <br /> <br />CONTRACTOR SECTION? <br />Company /f (!;(i /:: <br />~~ ~~ State Cert. or Regist. !F <br />City License Registration <br />****************************************** <br /> <br />~ot1' { c-I <br />c <.: '- 6 Cl S Y77 <br />iF -7/ <br />, <br /> <br />BUILDER <br /> <br />Si!!nature <br /> <br />Company <br />State Cert, or Regist, # <br />City License Registration ~ <br />****************************************** <br /> <br />ETFCTRIC1AN <br /> <br />Company <br />State Cert. or Regist, 'F <br />City License Registration # <br />**********************t-******************* <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. IF <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAl <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration .# <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />~********~************************* <br />a~tr- .o/l~J <br /> <br />PERMIT OFFICER, <br />