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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />'~fAF/~ <br />~ 70 <br /> <br />y u fh9-S <br />( <br />S"(~~/'\./ <br />, <br /> <br />fhw tel kHONE <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />G. (:, I~ OLl) IJ/~ /<./) <br /> <br />LOT SIZE~X 0<:) AREA SQ. FT. <br /> <br />JOB LOCATION <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.:" <br /> <br />a~ <br /> <br />c;2-C-J <br /> <br />~/ <br />, <br /> <br />tfDl () <br /> <br />6 S-/ {)() <br /> <br />(flJ/{J <br /> <br />WORK PROPOSED:_New Constru,ction _Addition _Alteration _Repair _Install <br />-ro ;vS77H:-i. /'f) )(~2. ~ F ollU . <br />_Sign/Temp. _Sign _Move _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 />BUJLDlNG 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 FORI1S. ,,,': <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. H <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 />_MEf:HANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_h'.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 />BUILDER <br /> <br />CONTRACTOR SECTION c-> <br />. Company 0 ()J../.5~ <br />~ ~. State Cert. or Regist. it <br />c-o',- . t'.A .2-'... Ci ty License Regis tra tion lfr <br />****************************************** <br /> <br />#C.- () It' I ~ tI /7 <br />77 <br />, <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert. or Regist. # <br />City LIcense Registration # <br />****************************************** <br /> <br />Si!?"nature <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration 4 <br />**********************t-******************* <br /> <br />MECHANICAl <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />OTHER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registratinn lfr <br /> <br />***********~****************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />