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<br />APPLICATION FOR PER~IT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />:%~ /J1 <br /> <br />APPLICANT <br /> <br />PHONE <br /> <br />ADDRESS <br />OWNER ~---o 8,,~J <br />JOB LOCATION ? '--? /~ .: ~U 8.t---/ <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 1. D. ~F <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 />____IF of Uni ts <br /> <br />__M/H <br /> <br />____Commercial <br /> <br />_Indust. <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />, <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 />,,' <br />_MECHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_H.R.E.C. <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 />****************************************** <br /> <br />Signature <br /> <br /> <br />CONTRACTOR SECTI~ <br />Company enTrI~{;' ~Nfr; <br />State Cert. or Regist. # C&C 009ZP;c:' <br />City License Registration # _5 ~9' <br />. <br />****************************************** <br /> <br />:::;~ Company f,?i~,tr ,E/~c,Tr"L :r~c-, <br />. 7 _ _ _ /' d ../'J' -# S~ate ~ert. or R~gis t. . ~F ~-"rtf)tPc l?"' 7 '7 ~ <br />__5:.____~_~ C1ty L1cense Reg1stratlOn # d13'( <br />****************************************** <br /> <br />PLl!MaF.~ ~ /.. <Sl.J t, ~ <br /> <br />S1gnature ~:il. ~ <br /> <br />Company 4 Ii 1... ^ ~ €A' j, ('\}/ (J I.- u M b; IV... 9 <br />State Cert. or Regist. t! (i> r ~ 0 11 / ~/ <br />City License Registration # <br />**************~*************************** <br /> <br />Signature <br /> <br /> <br />Company /,J. '5;1 lAyJ&&/rN I<-P. LI1-!t6-0) rL-; 3l.Jbl./1 <br />State Cert. or Regist. # <br />City License Registration 'F //7 <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 />PERMIT OFFICER. <br />