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<br />APPLICATION FOR PERNIT <br />CITY OF ZEPHYRHILLS <br />BUILDING OEPARTMENT <br /> <br />APPLICANT <br /> <br />:; uA-( 5"'tfr Il./~ M-c (C) fZ-y <br />?<65 ~ jK I{-r/~I <br /> <br />PHONE <br /> <br />?gy' Cj5??J1. <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />JOB LOCATION <br /> <br />~Y'll'l ~ (-(Ie c.s <br /> <br />. <br /> <br />tift /(/at!:SIZE4x4 AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. iF <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 llni ts <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_I <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,** <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 />_ME'CHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_\V,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 C3' ,~A <br />Company v(/~~ <br />~ a State Cert, or Regist, IF <br />~/( l~ City License Registration iF <br />****************************************** <br /> <br />4U!.Jf rV d If cUfC <br />11. <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 />PLL'MBER <br /> <br />Company <br />State Cert. or Regist, # <br />City License Registration # <br />**********************~******************* <br /> <br />Signature <br /> <br />MECHANICAl <br /> <br />Company <br />State Cert. or Regist, # <br />City License Registration 1 <br />****************************************** <br /> <br />Signature <br /> <br />OTHER <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />