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<br />APPLICATION FOR PERl'lIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />I'J <br /> <br />APPLICANT ~U-N ~.~ <br />~\SL~\ ~'~ <br />"bl'\~9..~ C-~b\L~ <br />U~i:> ~ <br /> <br />~\...)..,'\('\ <br /> <br />ADDRESS <br /> <br />~~ <br /> <br />PHONE( ~ ~- -r~ <::) <8 <br /> <br />OWNER <br /> <br />JOB LOCATION <br /> <br />LOT SIZE~~ AREA SQ. FT. <br /> <br />--- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION l;:) \~<~(lh m t\.'? <br /> <br />PARCEL I. D .IF <br /> <br />/ Jf - .:2.h - ;? /- {) 0 0 () - C /J ;;< 0 0 - (} () (J i) <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 />____4F of Units <br /> <br />,____M / H <br /> <br />____Commercial <br /> <br />____Indust. <br /> <br />____Swim. Pool <br /> <br />Other <br /> <br />> ____Restaurant & Health Departme~~pproval <br />BUJLDING SIZE: In x~, 4-Cu Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORI1S.'''': <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ~d. <br />**COpy OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br />,~ <br />____MEt:HANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\oj.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 /> <br />CONTRACTOR SECTION <br />Company ~'^~ S\ ~ (J~ <br />State Cert. or Regist. # <br />City License Registration # " <br />****************************************** <br /> <br />ElECTRICIAN <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 1 <br />**********************~******************* <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />