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<br />APPLICATION FOR PER~IT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />/7/1/1 b r 0 ~ 41' <br /> <br />Ii /1,' j.. t ./ r" <br /> <br />ADDRESS <br /> <br />r, (, (.' ? t(J <br />,...i '<). :) ..:, r <br /> <br />#~ ; h ti r. /. r (,li r \ <br /> <br />""".-, .."" ..... <br />PHONE i 'j" U <br /> <br />*"1 7 'I <:' <br /> <br />OWNER <br /> <br />.t::.J ' , <br />r' /Il, t) (n ',' <br /> <br />/\1"1 " J, j...., r <br /> <br />JOB LOCATION <br /> <br />"/"",-\ <br />'~(~'(f1; <br /> <br />H'L; <br /> <br />Ie h " f-" <br />f'\' \ r-~ ,~ <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 1. D.1F <br /> <br />WORK PROPOSED:____New Construction ____Addition ~Alteration ____Repair ____Install <br /> <br />____Sign/Temp. <br />PROPOSED USE: ~Single Family <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Demolish <br /> <br />_M/F <br /> <br />_1F of Units <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 />; I <br />t. . <br />I...., X <br /> <br />~( , <br />LJ. , <br /> <br />J ~- ,> <br /> <br />Square Feet, <br /> <br />f)!ld<f'r- <br /> <br />r f.L) r Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLAKS & (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 />:4"- <br />1000 <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <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 <br /> <br />_Frame __Steel <br /> <br />x <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: I~ "~-~;. <br /> <br />****************************************** <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist, # <br />City License Registration # <br />*********************k******************** <br /> <br />BlJILDER <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <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 /> <br />OTHER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist, # <br />City License Registration # <br /> <br />APPLICATION APPROVED BY <br /> <br /> <br />.~*~;:******************** <br /> <br />~))~ .,- <br /> <br />PERMIT OFFICER. <br />