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<br />APPLICATION FOR PERNIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />s~ ~~ Lt h.t l\s" 'F( PHONE ~ I ~ 7<02-7/33 <br />OWNER E 5-J Cl(" +-e.- 0 ~ s +~ J( 4.. U. II ~ ~ ,::Y 1-:[: 1'/ Q. V k- &AJD ?.e ~~l Kap. <br />JOB LOCATION 5b~ I 'B f-h -sl- ;Z-epA'7yh;,{(~ LOT SIZE_X <br /> <br />5" 'i-/ l <br /> <br />~t-k <br /> <br />AREA SQ. FT. <br /> <br />,(:. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />11-- ?--/&:. - 2-/ <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 />____4F 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 />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.,~'k <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 />_\\l.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 />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Si2:nature <br /> <br />Company <br />State Cert. or Regist. # <br />City License ~egistration # <br />****************************************** <br /> <br />ElECTRICIAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <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 <br /> <br />**,* * **** ***.**0/*,***** * ** ** * ** *,~ * * * ** * * * of, * <br />'--'~'/ ,', \'- .-'--? ~ ' <br />BY / /d ;{~ I'~ {/'\A'I--z.." j . <br />'{ <br /> <br />\J <br /> <br />PERMIT OFFICER. <br />