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<br />~ <br /> <br />. \ <br /> <br />, '-','J <br />, ' <br /> <br />. ' <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />\tV <br />78y,103<1 <br /> <br />APPLICANT <br /> <br />#jlAt!'77E~- _) M17// <br />,//41 ,J / <br /> <br />OWNER <br /> <br /> <br />PHONE <br /> <br />?r'? ',3f"2;f <br /> <br />ADDRESS <br /> <br />,...... <br />C j 4 ,'f,' If I" f <br /> <br />L' I' <br />JOB LOCATION ,,',//2 f" /,-[;../7; / <br />7/)fl to T' /1 -. _.- ( /'t -1 r <br />LEGAL DESCRIPTION: LOT(S) ;? <br /> <br />,L<)T SIZE.iP.!L-X fY, J- AREA SQ, FT, 9'/fj-{) <br />/i"'i/ot:' K - 'of-) ., '7i-' <br />BLOCK 2. SUBDIVISION /6 /J - / (:5 t11i/ <br /> <br />PARCEL I.D. # /) '2 - 2 Cv '~"2 1- C'l / t t..'; " L;' () 2. ,l () - c.:> (J ') () <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 />____4; of Uni ts <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 FOR~S.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />V;UILDING <br /> <br />$ <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 />ELECTRTCTAN <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Si2:nature <br /> <br />Company <br />State Cert. or Regist, # <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />****************************************** <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 />d'/1I1'.4(f "e /I.,dv,;J- , <br /> <br />PERMIT OFFICER. <br />