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<br />APPLICATION FOR PER}lIT <br />CITY OF ZEPHYRHILLS <br />~ BUILDING DEPARTMENT <br /> <br />APPLICANT ~q\ b SeLf 0/ <br /> <br />ADDRESS_ [3 '3 z-- So tI w ~ IS D.c. PIIONE <br /> <br />OWNER Ie (/ J +- ,Y Ifes./Il . j t ~ J I (;~ (),\ u.. It- L <br />c:--- --rc r"- S-L <br />JOB LOCATION \)) (0 t f . I LOT SIZE_X <br /> <br />~ (~') ~ S-~~O <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D .1F <br /> <br />WORK PROPOSED:____New Construction _Addition ____Alteration ____Repair _Ins tall <br /> _Sign/Temp. _Sign _Move _Demolish <br />PROPOSED USE: _Single Family _M/F _iF of Units ,_H/H <br /> _Commercial _Indust. _Swim. Pool Other <br /> <br />, <br /> <br />_Restaurant & Health Department Approval <br /> <br />ButLDING 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 />hI ~CtJ ~ <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 />'.1 <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 <br /> <br />_Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />Signature <br /> <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION I <br />Company ,Sr. ,~ ~-e,....- <br />State Cert. or Regis\:' iF <br />City License Registration iF <br />****************************************** <br /> <br />{,O/I_ I t- Co <br /> <br />"i Z-- <br /> <br />ElECTRICIAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Si!!nature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />**********************f.******************* <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration iF <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY /!;:::~*;~";:!r:~"""*.***"**'" PER"IT OFFICER. <br />