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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />OWNER <br /> <br />~D '3c{ <br />(a t> U-r <br />,c-6 j Y- <br /> <br />/7,( ;;n- <br /> <br />Ifh 0 1:'5 <br />/71<- c; '/ <br /> <br />PHONE <br /> <br />7x)-- ,? J -3 '3 <br /> <br />ADDRESS <br /> <br />JOB LOCATION <br /> <br />LOT SIZE /(;'J X I SO AREA SQ, FT. <br /> <br />LEGAL DE~g~JrlION: LOT(S) <br /> <br />~'.D.!~ <br /> <br />WORK PROPOSED:____New Construction <br /> <br />fI <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />1/ <br />I I <br /> <br />-:26 <br /> <br />,~I <br /> <br />Ou!() <br /> <br />,2I00U <br /> <br />O~(J <br /> <br />_Addition <br /> <br />_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 />____IF of Units <br /> <br />._M/H <br /> <br />____Commercial <br /> <br />_Indust, <br /> <br />_Swim, Pool <br /> <br />Other <br /> <br />.~ <br /> <br />____Restaurant & Health Department Approval <br /> <br />BU1LDING SIZE: <br /> <br />1.2- X 9A\ <br />.~, <br /> <br />c2Vo <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~S,** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. H <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />$ <br /> <br />?Dh <br /> <br />()'l <br /> <br />_BUILDING <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />.f <br />_MECHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp, <br /> <br />_W.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 <br /> <br />____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 Reg i ~ Lra lion " <br />****************************************** <br /> <br />BUILDER <br /> <br />7/ <br /> <br />ElECTRTCTAN <br /> <br />It( <br /> <br />Company <br />State Cert. or Regist. {f U. (')6D 4k C/o <br />City License Registration ;,= SO <br /> <br />Signature <br /> <br />****************************************** <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration ~ <br />**********************~******************* <br /> <br />PLL'MBER <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 Regist;ration IF, <br /> <br />OTHER <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />