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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMEFT <br /> <br />APPLICANT /1V-}/ (fJ ;q9~N'?ll C9YJI!AlT,,/ I\.r /' <br />ADDRESS 1/'191 6'E))I7Je 6f ~iJk(j Ilk; FI ~3'~(/PHONE 9.ot/~ ?99~,-~~)O <br />OWNER f! / R-n nil / K<; <br />JOB LOCATION &'0,-% 7?))')9~ l.lJf-}j LOT SIZE~X/M / AREA SQ. FT. <br />I <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION )?~Jly;? -;r/~Ar <br />PARCEL I. D. # 3-.;24> -;;lJ - 0/36 ~ ()/)/X)o - () '-/70 <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_I <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 />PERMITS REOUESTED <br /> <br />vBUILDING <br /> <br />$~, 3l1(J.oO <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />, <br />_MECHANICAL <br /> <br />$ <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 />Signature <br /> <br />d~ ~ob <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regi t. # <br />City License Registration <br />****************************************** <br /> <br /> <br />BUILDER <br /> <br />ELECTRICTAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />PLUMBER <br /> <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />*********************~******************** <br /> <br />Signature <br /> <br />f, <br /> <br />~o ~:f~"" <br />~ ~~ ............... iJ#~,' , <br />~'.c.."',":o.AT" ..' , <br />sliiu~e~fI! - t)~::> "', <br />- . <br />:::'- l <br />: "!t~~~.. J ,....~-:- <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />**********************k******************* <br /> <br />QTH$ ;~~:;,;,~: " : <br /> <br />"""Y~ .... '" . <br />. '. 0 '. " , 1F1\J<'\ ,',' <br />Si~~e.. ......., <br />'-:.;,.11 :1 () . \..; <br />I !//-;;'JlIUB~t ',~' <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br /> <br />'~~Z:"~'" <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />