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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT !/!A/Ale.. A;Alfl2J~/'1 / ~/'//YR .4"e~ <br />..0 . <br />ADDRESS ..39::;'~9 &/a/A ~f' /3.P-Y/-5" ,.cC~~~~HONE <br />/ ' / / <br />OWNER a71Y/vC )'(;d;; ZJ~),/l--1 <br />JOB LOCATION .79,$~y &7~~ ~~ LOT SIZE_X <br /> <br />~~, _ .t/~..? / <br /> <br />AREA SQ,FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. jfr <br /> <br />WORK PROPOSED:____New Construction _Addition _Alteration ____Repair ____Install <br /> _Sign/Temp. _Sign ____Move _Demolish <br />PROPOSED USE: ____Single Family _M/F _# of Units __M/H <br /> Jf? P40t';JN~/~h!l/C!- <br /> _Commercial _Indust. ____Swim, Pool <br /> <br />J <br /> <br />_Restaurant & Health Department Approval <br /> <br />BuiLDING SIZE: <br /> <br />x_. <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />A TT ACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR.'1S. '''' <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS,** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />-LELECTRICAL <br /> <br />v ,,' <br />~MEtHANICAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp, <br /> <br />_".R.E.C. <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 />CONTRACTOR SECTION <br />Company <br />State Cert, or Regist, # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />RLRCTRr CrAN '\;2 ~"'~"- , ~ Company '2 - \\'>.L "> F Lcq, <; €Ci\.u, <br />c---~ (~) , ). l State Cert. or Regist. # OVCJ '2...(('" r <br />Signature'~, ,,~ ." ~-- '----' City License Registration lfr {O <br />~. **~************************************** <br /> <br />PLUMBER Company <br />State Cert. or Regist. iF <br />Signature City License Registration i~ <br />**********************~******************* <br /> <br />Signature <br /> <br /> <br />Company ~AI ~.t.VA/e'Y <br />State Cert, or Regist, i,= r '.2?/k}t:')d'0 ~Zb <br />City License Registration IF . E'P <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERmT OFFICER. <br />