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<br />APPLICATION FOR PERl'IIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br />/ {'r,J Of)] (I; vli?';S 6;J,!d,G" <br />ADDRESS v; ;\ <br /> <br />floe) F <br /> <br />(;v GRLeY <br /> <br />OWNER <br /> <br />L.L- () 1.1 D <br /> <br />/uJtL 5 <br /> <br />, <br /> <br />1/11t (we <br /> <br /> <br />-- <br />V, IYl/, 0. <br /> <br />c".f '7 7/)) G, 1ft _ If / )' <br />I UL.--- J J [,. PHONE I / - [" <br /> <br />JOB LOCATION '5 7 I Y-3 <br /> <br />3]S'Y c> <br /> <br />LOT SIZE_~ AREA SQ,FT. 3~ b -- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D, iF <br /> <br />--1l..Repair <br /> <br />:..--,Ins ta 1 i <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration <br /> <br />_Sign/Temp. <br /> <br />_Sign <br /> <br />_Nove <br /> <br />_Demolic !, <br /> <br />PROPOSED USE: ~Single Family <br /> <br />_M/F <br /> <br />_IF of Units <br /> <br />,_1'1/H <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />_Swim, Pool <br /> <br />Other <br /> <br />'1 <br />~I <br />"( <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUJLDING SIZE: <br />t <br /> <br />X_I <br /> <br />Square Feet, <br /> <br />HeiF!': <br /> <br />RESIDENTIAL: <br />COMNERCIAL : <br /> <br />A TT ACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR!'IS." <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORl'IS. H <br />**COPY Of CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />V BUILDING <br /> <br />it, / J. q /,/""l .">eI <br />$tt!. +- . ,)U <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\';,R,E.C. <br /> <br />~t <br />_MEOHANICAL <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />Valuation of Mechanical Installation <br /> <br />~ROOFING SPECIALTY <br /> <br />s <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br /> <br />****************************************** <br />CONTRACTOR SECTION . J <br />Company fi')r)F Iv 9/( /{;1 <br />State Cert, or Regist. " CCCC'F~_S-~'77 <br />City License Regist.ration ;, 7/ <br />********************************* <br /> <br />Signature <br /> <br />ElECTRTCTAN <br /> <br />Company <br />State Cert. or RegisI'.. ~ <br />City License Registration " <br />**************************************~*** <br /> <br />Si'mature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration ~ <br />****************************************** <br /> <br />PLl:MBER <br /> <br />Signature <br /> <br />Company <br />State Cert, or Regist. t <br />City License Regis tration .. <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 />31~ L~~~L****::f1** ***~*~~~**~~~~~~~~~~~~~~~~ <br />- ..-...... ... -.... ......................,......... <br /> <br />dA\ 111 ...~.1 L~J)N-' <br /> <br />PER~IIT OFFICER, <br />