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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT QtJS5e~L fV1 . 1JJrg()(u)....{ <br />. <br /> <br />ADDRESS g 4-~ t1:N r..-GJ4' c. T '7,c: pH'I7?HII LS- <br />OWNER >10.5sCLL Iv1- 13R.O/.vN <br />'f ? A.5 <br />JOB LOCATION Ccu12 I sT: <br /> <br />3>3S4l <br />Fe. PHONE <br /> <br />'7 B6 -7824- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL I.D.~F Qk.LDJZTJ <br /> <br />ZEPHYRHIU<' <br />.:<4-" <br />Pt..J4-T <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />BLOCK <br /> <br />SUBDIVISION CHf1LFoNI <br />PJ4&6- 8 S <br /> <br />VILLi"l~ <br /> <br />~K2q <br /> <br />WORK PROPOSED:~New Construction _Addition _Alteration _Repair _Install <br /> _Sign/Temp. _Sign _Move _Demolish <br />PROPOSED USE: ~Single Family _M/F _# of Units __M/H <br /> _Commercial _Indust. _Swim. Pool Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />} /? I if 'If <br />BUILDING SIZE: "'r....:;J 8 x3Cf 0, 1 '703 Square Feet, <br /> <br />73 r /") t; /l.i-6L- EA ~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 FORl'lS. ,~* <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />VBUILDING <br />...:LL-ELECTRICAL <br />v'MECHANICAL <br />-LLPLUMBIN'G <br /> <br />$ 30 cx:x:J <br /> <br />Valuation of Total Construction <br /> <br />/cQ5 <br />$ 1100 <br /> <br />AMP Service <br /> <br />L/ Florida Power Corp. <br /> <br />_"l.R.E.C. <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ~Block _Frame _Steel <br />FINISHED FLOOR ELEVATIONS: 11FT. <br /> <br />Other <br /> <br />****************************************** <br /> <br />Signature <br /> <br />Q{)}.~ m:b~ <br /> <br />CONTRACTOR SECTION~ ~ <br />Company (JC:S6L1 <br />State Cert. or Regist. # <br />City License Registration <br />****************************************** <br /> <br />~/~ ~2g~2'11 <br />iF _ Q 4- '3 <br /> <br />BUILDER <br /> <br />El,ECTRTCT AN <br />Signature ~t.--~ tvl13~ <br /> <br />Company 9V.sS~L.L J/1_.r9Qoevg <br />State Cert. or Regist. jF~'I.<... 60/ 65 I <br />City License Registration iF jb8 <br />****************************************** <br /> <br />Signature <br /> <br />Company Q u'. C,ELI {Vi ~ f), 0 w I....{ <br />r-:J State Cert. or Regist. j,f-.C.J.- CDs)' 4 qcr C:, <br />(.(~ '}11. S6t-~ City License Registration iF , /01 <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Q~Q M.'i3;H~ <br /> <br />Company Y< () c; c; ELL P1. S3 Ro Lv N <br />State Cert. or Regist. j,! c.. J4 COI+IZ.C;4- <br />City License Registration iF II <br /> <br />MECHANICAL <br /> <br />*************************************~**** <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY JJ;';;;;~' ~;~;;r"***'''' :,* *, **' * *.. ..* PERMIT OFFICER, <br />