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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT -:7.fI1I tfJ/l5/JN~1 (l bm~ I/\IC- <br />ADDRESS //'191' c~b~ <..f: g;u:ok:ct II&' r/ <br />II/!:TJII t.L e _ <br /> <br />PHONE 9ot/~ 75?9-0d70 <br /> <br />BLOCK <br /> <br />LOT SIZE~xIOD/ AREA SQ,FT, <br />SUBDIVISION 2L:fJ?1-I.e.--f?JJx;6" <br /> <br />PARCEL I. D , # ~I ' ~ - 03 ~ 0/300 . OOLKJ(") - oooo~.V <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 />_# of Units' <br /> <br />__M/H <br /> <br />____Commercial <br /> <br />____Indust, <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />_Restaurant & Health Department Approval <br /> <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 />~DING <br /> <br />PERMITS REOUESTED <br /> <br />$ <br /> <br />~ooo. 00 <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 />i <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />____PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br />(JOAl&z.id-r&" Other <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_Frame ____Steel <br /> <br />FINISHED FLOOR ELEVATIONS: FT, <br /> <br />****************************************** <br /> <br />BUILDER <br />Signature ~~~ ~ <br /> <br />CONTRACTOR SECTION <br />Company Ie <br />State Cert, or Regist. # <br />City License Registration <br />****************************************** <br /> <br /> <br />Signature <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />*********************F******************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />f, <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 # <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />~********~************************* <br />a.M .tU ~ r/ AI"r-,...., T <br /> <br />PERMIT OFFICER, <br />