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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />S~LJeR/OR &cpr,..";uq ~ ~Q04~q ~;7 ~c.,. <br />,,/ ...., v../ , <br />ADDRESS ;ifr ~9'/fU" S~ #4-~ o/~'A'9'A.". /"4 J'n-- 77 PHONE <br />v ~ <br />OWNER AZQ Sc-C)# <br /> <br />JOB LOCATION 60/3 /7~ <br /> <br />APPLICANT <br /> <br />783- 7.s-07 <br /> <br />?Y/r,r;.~~ 37.51tJ 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.# <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 ,_M/H <br /> <br />____Swim. p$ C"'?'.vqe OpT ..;;?h Other <br />%',,)' -y~'T 5js7e"'1 <br /> <br />_Commercial <br /> <br />_Indust. <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 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 />Valuation of Total Construction <br /> <br />____ELECTRICAL <br />-XME'CHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />$ <br /> <br />::1. ~OO ~ <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 />****************************************** <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration 4F <br />****************************************** <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Si!mature <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br />Signature ~ d <br /> <br />Company ~~e,e,e,.e &'I';r;~9' ,L-&L'"f~ ~/ ~c, <br />State Cert. or Regist. ~F cACO 1'7.:/7/ <br />~ City License Registration IF <br />n***************************************** <br /> <br />OTHER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 4F <br />City License Registration # <br /> <br />APPLICATION APPROVED BY <br /> <br /> <br />PERMIT OFFICER. <br />