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<br />APPLICATION FOR PE~~IT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />5u;tJ ~~" ""'/i> <br />/ <br /> <br />ffiq T/~.J ~ aC)~7 ~ T <br />A - /0 cJ.t/SMf'~ /.4 PHONE <br />~77 <br /> <br />...2'-;> C' , <br />7,S3-?..s-O? <br />. <br /> <br />OWNER <br /> <br />aUq~.s S?: <br />../ <br /> <br />~AN"""'~ S"' S-r:'c;>A.1 /q",./ <br /> <br />ADDRESS <br /> <br />~31 <br /> <br />JOB LOCATION ~7'Ty' ~~.../c.4 ~R. Z~/~v''?,..A ~,4. LOT SIZE_X <br />.:? .Y5"9/ <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br /> <br />AEEA SQ,FT. <br /> <br />PARCEL I. D. 4F <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 />____fF of Units <br /> <br />_M/H <br />.~~2#J'h/ Other <br />. <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />_Swim. Pool <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 />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />~MECHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\~.R.E.C. <br /> <br />$ <br /> <br />:2, '?OO <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 />Signature <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. if <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />ET FCTRI C1 AN <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />Signature <br /> <br />~ ' I;~ ~~ <br />Company ..J D't!!~"O}J. /9~9r-/. ~ ~';;,; 'J .~r..zc.,c.. <br />State Cert. or Reg1st, iF - ~ ~ <br />City License Registration J <br />****************************************** <br /> <br />PLUMBER <br /> <br />MECHANICAl Company 5~A"1'';'"p &d/:Uq ~ eC'{;'i ~7 ...7/w:. <br />,. State Cert. or Regist. 1,' ../ c~co _671 <br />Signature ~ a ~_.J'-+'t- City License Registration :~ <br />, ****************************************** <br /> <br />OTHER <br /> <br />*** <br /> <br /> <br />Signature <br /> <br />if <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER, <br />