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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT J: c /1-' A/ ~ L l'\ 6 j.. /U t; J.. <br /> <br />ADDRESS ,.;.;r~ /'1 f <br /> <br />/:.2 II V€" <br /> <br />PHONE <br /> <br />7Y~. <br /> <br />3'ir~() <br /> <br />OWNER <br /> <br />J 1\ I'Y\ es VJ t11 A..$ 6 AJ <br /> <br />JOB LOCATION 38 I Y i ,~ A V<E <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.4~ II - oZ' -:J..../.- 0010 - 03';1. O(j.- LJ()J"O <br /> <br />........ .-" <br /> <br /> <br />~pair <br /> <br />_Ins tall <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration <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 />_4~ of Uni ts <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 />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 FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMs.'a <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br />Y'ELECTRICAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <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 />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Signatur~ <br /> <br />Company .j <)1\ TL1 1\, I c... J, Ii )- d~ 51 D /\/ ~ 1.. 6(;1,. <br />'7P ,17.0 J --+..---, State Cert. or Regist. 4r'~O(jtlC> 7 If <br />!J.....~~~ City License Registration # :2 '2.. <br />****************************************** <br /> <br />ELECTRTCTAN <br /> <br />-;lS,I. <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <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 Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br /> <br />. <br /> <br />:3 r!f/0.~"i-- ~~ -y ) b.!vzre[ <br />