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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER <br /> <br />Sre~/a~ ~<?~/~'1 ~ ~~o/;.y <br /> <br />;7~/c&/'If~OVdq.5 // #~-/o <br />,/bS'eLJ -< ko~~ <br />/ <br /> <br />/l4r- <br /> <br />v <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />~N'C.. <br />$S'Y -3P-V9 <br /> <br />APPLICANT <br /> <br />JOB LOCATION .15'floI'7 Mw ~/ ..Aye ~L~.. 3'~OT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. 4F <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ~Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />_Move <br /> <br />____Demolish <br /> <br />____Commercial <br /> <br />____Indust. <br /> <br />____Swim, Pool <br /> <br />_____M / H <br /> <br />.-j/e ~........ck~Other <br />(!"i17A/Jt2 our <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____~~ of Uni ts <br /> <br />____Restaurant & Health Department Approval <br /> <br />BuILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br />oJ' <br />~ECHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp, <br /> <br />_W.R.E.C. <br /> <br />$ <br /> <br />/9"05 <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 4ft <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Sil;mature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration j~ <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert. or Regist. 4ft <br />City License Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Signature b-~ <br /> <br /> <br />Company S':/leR/o~ ~<?//~Cj~~ ao~Jy ~r...z;..c: <br />State Cert. or Regist. ~#', ,{,/fC'o~?.;z7/.. <br />City License Registration # <br />**************************************** <br /> <br />Company <br />State Cert. or Regist, # <br />City License Registration 4ft <br /> <br />OTHER <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br /> <br />\ <br />"'- <br />