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<br />APPLICATION FOR PERJIlIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT ~cw.\ ~,- Gx.~~~ <br />ADDRESS 8~d-. .s. IJuJ?; 'T6 ~ US PHON~} - fSSSO <br />OWNER L Lh~ tV m ,,!JJC.cJ t:::... hi ;;?JI B ECTH w' · V\J I AI s 1-.0 J; <br />JOB LOCATION ~ tfO I S+AIH - L I..J~ ,LOT'SIZE_X AREA SQ.FT, <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I, D. ~F <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install <br /> ____Sign/Temp. ~Sign _Move ____Demolish <br />PROPOSED USE: _Single Family _M/F _iF of Units ._M/H <br /> _Commercial _Indust. _Swim. Pool Other <br /> <br />, <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 FOR.'1S. '''' <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 />>-4' <br />_MECHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_H.R.E,C, <br /> <br />$ <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />Valuation of Mechanical Installation <br />~ROOFING SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />_Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />L/-q ~ <br /> <br />Signature <br /> <br /> <br />****************************************** <br />CONTRACTOR SECTIO~~ /J J J. <br />Company r L8VzJ7'rUC~ <br />State Cert. or Regi t. iF KC, OOSlP'?fo.."1 <br />City License Registration if q.;;... <br />*********************************** <br /> <br />ElECTRICIAN <br /> <br />Company <br />State Cert. or Regist. iF <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />PLUMRER Company <br />Sta~e Cer~. or Regis~. # <br />Signature City License Registration ~F <br />**********************ft******************* <br /> <br />MECHANICAL Company <br />State Cert. or Regist, # <br />Signature City License Registration ;f <br />****************************************** <br /> <br />OTHER Company <br />State Cert. or Regist. iF <br />Signature City License Registration # <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER, <br /> <br />