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<br />APPLl.CATl.ON FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER <br /> <br />UolfA)S 5TJ:M+ SFA{lOyk <br />5f5:~6/ (I( Slf.E- <br />,4K(~S ?:rA(~5 <br /> <br />PHONE <br /> <br />.7<3'3-1 b ~> <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />" <br /> <br />JOB LOCATION <br /> <br />LOT SIZE <br /> <br />x <br /> <br />AREA SQ.FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. # <br /> <br />WORK PROPOSED:____New Construction _Addition ____Alteration _Repair ____Ins tall <br /> ____Sign/Temp. _Sign _l"1ove ____Demolish <br />PROPOSED USE: ~Single Family ~/F ____~~ of Units ,._M/H <br /> _Commercial _Indust. ____Swim. Pool 5:RJ:- + iJf:/f 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 FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORNS.** <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 />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 />Signature <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. a <br />City License Registration 6 <br />****************************************** <br /> <br />J3UILDER <br /> <br />PT.1lM8F.R 1!r. Company (' /Iii /s AAN t ~ I}. 1M h;;J 6 <br />/1 ~ --A j) (J III j) State Cert. or Regist. 4! ' . F () /~t;ff <br />Signature L' _-0fY/cI?1 -2). (l)aA---l City License Registration jI .S 7 <br />****************************************** <br /> <br />Company <br />State Cert. or Regist. 6 <br />City License Registration 6 <br />****************************************** <br /> <br />ELECTRTCTAN <br /> <br />Shmature <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 6 <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAl. <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration # <br /> <br />OTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />**~********~************************** <br /> <br />7L rP0 A)A'd . ~ . <br /> <br />PERMIT OFFICER. <br /> <br />..:/ <br /> <br />:";~<,:- <br /> <br />I '~ <br /> <br />.~ .. , <br /> <br />~ ,-' ~~.. <br /> <br />J .~ <br /> <br />i : <br />~. l;"," . <br /> <br />" ". <br />