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<br />APPLICATION FOR PERNIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT ~Cl.M \ <br />ADDRESS 8.3 d--. 6 <br />OWNER ~h.o r-t <br />-5037 <br /> <br />'-- 'S~~>- <br />\.Ju.)~ 9~ <br /> <br />I:'~~ n<..f\..p r <br />GAil Dll1~ <br /> <br />PHONE <br /> <br />5lc>7-,f S cf () <br /> <br />JOB LOCATION <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.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 />PROPOSED USE: ____Single Family <br /> <br />_M/F <br /> <br />_4~ of tlni ts <br /> <br />,____M I H <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />_Swim, Pool <br /> <br />Other <br /> <br />, <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 FOR./1S.'''': <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 />_MECHANICAL <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 /> <br />CONTRACTOR SECTION ~. <br />Company 't:.: 11) Y <br />State Cert, or Regist, # <br />City License Registration # <br />*********************************** <br /> <br />COu.~-hu..(~ '- <br /> <br />Signature <br /> <br />ELECTRICIAN Company <br />State Cert. or Regist. # <br />Signature City License Registration ~ <br />****************************************** <br /> <br />PLUMBER Company <br />State Cert. or Regist. # <br />Signature City License Registration # <br />**********************~******************* <br /> <br />MECHANICAL Company <br />State Cert. or Regist. # <br />Signature City License Registration iF <br />****************************************** <br /> <br />OTHER Company <br />State Cert. or Regist. # <br />Signature City License Registration 4F <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br /> <br />