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<br />APPLICATION FOR P~RMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />~hrM <br />~q 314 <br />~~ \3"oh.:J <br />aq 3J4 <br /> <br />~..tl <br />S-Hl.4uL <br /> <br />'~IlJl <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />7RK- ("j/MJ' <br /> <br />OWNER <br /> <br />('eJoo7/) r II <br /> <br />PARCEL 1. D. j~ <br /> <br />~J, AtJE... LOT SIZE ,D X I ()'O AREA SQ. FT. 7MIJ <br />({"J BLOCK -2.. SUBDIVISION .z,~4j" J..irit1:rf:r / aI AJOiI/I>N <br />1~"'.2({J21-~40- ~~('JO- ~Q <br /> <br />JOB LOCATION <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />WORK PROPOSED:~New Construction ~Addition ____Alteration <br />SCA..&CAJ R.,;w, / eoAJ u.t.tlt. <br />____Sign/Temp. ____Sign <br /> <br />_Repair <br /> <br />_Install <br /> <br />_Nove <br /> <br />_Demolish <br /> <br />PROPOSED USE: ~Single Family <br /> <br />~/F <br /> <br />_j~ of Uni ts <br /> <br />, ,____M / H <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />BUILDING SIZE: <br /> <br />____Restaurant & Health Department Approval <br />1.:1 x Jv'i:/', ~~~m Square Feet, <br /> <br />7' <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORI-tS. ,~* <br />**COPY OF CONTRACT REQUIRED. <br /> <br />pERMTTS REOUESTED <br /> <br />-X-BUILDING <br /> <br />$ <br /> <br />if (J{) .!:!!. <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 />_MECHANIGAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br />/Jll'N) /eo~(,I./..~ther <br />I <br /> <br />TYPE OF CONSTRUCTION: ____Block ____Frame _____Steel <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br />BUILDER i-ItJ/JIll'. ~1U~Jl- Company <br />State Cert. or Regist. lj <br />Signature City License Registration a <br />****************************************** <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. a <br />City License Registration a <br />****************************************** <br /> <br />El,ECTRT CT AN <br /> <br />Signature <br /> <br />Cc,mpany <br />State Cert. or Regist. # <br />C~ty License Registration ff <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. a <br />City License Registration # <br />**************~*************************** <br /> <br />MECHANICAl. <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration ff <br /> <br />OTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />~***********~,*ft************************ <br />.&;;1 '. <br />/1 /1/f.A" (f /. c> /1 /1) ~ ') <br />(I . . <br /> <br />PERMIT OFFICER. <br />