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<br />APPLICATION FOR PER~IT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT fY7ftt...C/1f PO,rvJ /::> <br />ADDRESS 2> &' z Lf7 80 u NI]/ L/1/ <br /> <br />PHONE <br /> <br />7%2?'" c,Y"3 /.L <br /> <br />OWNER <br /> <br />/1'1 r-r t:..L u-.s <br /> <br />C'l!. 0 6" ..s <br /> <br />JOB LOCATION 3 f"7/:)' uJ4/l fV7 JtJS/61!- <br />LEGAL DESCRIPTION: LOT (S) / S 0 BLOCK <br /> <br />LOT SIZE~X ~() AREA SQ.FT, <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.# <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 />____4F of Units <br /> <br />_2-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 L\~ , <br /> <br />1/ () 5 fo <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 />oe <br />/ <j'O 0 <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\-l.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 />BUILDER POmP {O/f-/Sr: <br />Signature fZ1 C" ~ <br /> <br />CONTRACTOR SECTIO~ <br />Company f2.. r::1 1/ H rj- 50 /V .5 <br />State Cert. or Regist, # <br />City License Registration # <br />****************************************** <br /> <br />:?~'\ <br /> <br />ELECTRICIAN Company <br />State Cert, or Regist, # <br />Signature City License Registration # <br />****************************************** <br /> <br />PLUMBER Company <br />State Cert. or Regist, # <br />Signature City License Registration 1ft <br />****************************************** <br /> <br />MECHANICAL Company <br />State Cert. or Regist. # <br />Signature City License Registration 4F <br />****************************************** <br /> <br />OTHER Company <br />State Cert. or Regist. 4F <br />Signature City License Registration 4fr <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br /> <br />