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<br />~ <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />if. r ' / ";r'- (' )i. <br /> <br />\, <., .... <br /> <br />\'" {, <br /> <br />l_ \.....:. <br /> <br />~. I <br /> <br />i. <br /> <br />"'7-.. <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />V' I. ;'). <br />/ (',- <br /> <br />i <br />OWNER \... i., "K -./ <br /> <br />JOB LOCATION <br /> <br />. '~','", <br /> <br />, /' <br />},"f , <br /> <br />LOT SIZE~X / 36 ~REA SQ.FT. / 7 () <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL I.D.# ) .. ,'",~ ". <br /> <br />BLOCK <br />I .1 "I . <br />,~.,,( ......... .. <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED:_New Construction _Addition ~lteration <br /> <br />_Repair <br /> <br />_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 />_j~ of Units' <br /> <br />._M/H <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />. <br />BUILDING SIZE: <br /> <br />_Restaurant & Health Department Approval <br /> <br />/D~ :l~J <br /> <br />Square Feet, <br /> <br />/7D <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 />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 /> <br />TYPE OF CONSTRUCTION: _Block ~Frame _Steel <br />,~ <br />FINISHED FLOOR ELEVATIONS: I b FT. <br /> <br />Other <br /> <br />BUILDER <br /> <br />****************************************** <br />o (..(.."'1 -e yo ~ <br />C I.JJ.-.Y -1-0 V7 C (' u t.1 '" <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br />-..?" Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />o LU VJ v;> <br /> <br />L--- <br /> <br />ELECTRICIAN <br /> <br />() ( ..t) v1 'f> ,- Company <br />State Cert. or Regist.. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />*********************~******************** <br /> <br />PLUMBER <br /> <br />,I, <br /> <br />, , <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />