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<br />APPLICATION FOR PER~IT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT ~;l- U-Lc-hz; '" <br />ADDRESS .......~9/// ~G /Cd .. Z- 1-/.../6 <br />OWNER ~ /Z,(JI'IN M I V'T!::-/C. 7C3.A/ <br />JOB LOCATION ~z. Zfj; /O'6J1Sr~ <br /> <br />rM 3SSc.;O PHONE ~/3'7(3Z'~319 <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. ~fr <br /> <br />11- zC;, -Z,I <br /> <br />&010 <br /> <br />/91(JCJ <br /> <br />tJ Is-a <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ~Instal1 <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 />____IF of Units <br /> <br />,_N/H <br /> <br />____Commercial <br /> <br />____Indust. <br /> <br />____Swim. Pool <br /> <br />Other <br /> <br />! <br />/ <br /> <br />____Restaurant & Health Department Approval <br /> <br />BU1LDING 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 />_BUILDING <br /> <br />$~ <br /> <br />Valuation of Total Construction <br /> <br />J,/ ELECTRICAL <br />..f <br />.l:::...NECHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_h'.R.E.C. <br /> <br />$ -z-,:s~ f fR 7 <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 <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />::::::~ Company ~~ Gk<k;", <br />State Cert. or Regist. # <br /> <br />-. t~****...******~~;~.;~~;~~;.~;~;~;:~;~~~ 11 <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />**********************ft******************* <br /> <br />CC /z 68 <br />~5'1 <br /> <br />PLUMBER <br /> <br />MECHANICA~ Company ~-#iL ~C+Ii'<<-- <br />--p;--. J..) State Cert. or Regist. j,! ;re.."'i!){!)~qz.,tI5" <br />signaturell)(J/t/tfI.L.u- City License Registration iF (Jsr <br />****************************************** <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERt'IIT OFFICER. <br />