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<br />AP2LICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER <br /> <br />~ ~Km~ J....').' S,-\s.'\~ .N\'& <br />I Do.a I Hu.) '1 :30 \ <br />E ~ E... I.u<i.:- <br />. ~ ~1Ui4 <br />JOB LOCATION (oC;>.YO S-lL\JE.t. ~ftK.s ~ LOT SIZE~X /DC AREA SQ.FT.I~D+ <br />LEGAL DESCRIPTION: LOT(S) It./. BLJcits- I A. SUBDIVISION S,L.IIE.~ OA '<'S <br />PARCEL 1. D. # 0 3 0<G:, ~, D I ~A OOOOD () I c/ () <br /> <br />EJSn=.l=:.~ \<<:::..~.s.. ~ ~ <br />DAbi..-C1\'\"l-PHONE .:S~ \ St ~ <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />WORK PROPOSED:~New Construction ~ddition ~lteration _Repair _Install <br /> _Sign/Temp. _Sign ____Move _Demolish <br />PROPOSED USE: ~Single Family _M/F _4~ of Uni ts __M/H <br /> _Commercial _Indust. _Swim. Pool Other <br /> _Restaurant & Health Department Approval <br />BUILDING SIZE: X .,'tSD TiT Square Feet, I~' Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT, PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />~BUILDING <br />-LELECTRICAL <br />~MECHANICAL <br />-K-PLUMBING <br /> <br />$ <br /> <br />~<)Ooc <br /> <br />Valuation of Total Construction <br /> <br />~()D AMP Service <br /> <br />>< Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />$ c2 30C <br /> <br />Valuation of Mechanical Installation <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 />Signature <br /> <br />CONTRACTOR SECTION <br />[ED Company blF.lfIFtAJ S ~s.T~ ~ <br />.r- a .t State Cert. or Regist. # <br />.. ~ . \;' ....... Ci ty License Registration # c>;l/9 <br />****************************************** <br /> <br />BUILDER <br /> <br />:::::: ~ Ct ~ (~, . <br /> <br />G~IC:MrlD ~4~lEMS <br />State Cert. or Regist. # <br />City License Registration # /~I <br />****************************************** <br /> <br />Company <br /> <br />Signature <br /> <br />Company _EN\.lll?oNmufrAL OOA)[: <br />'- ~.1 Q5Q .. ~~~~e L~~:~~e O~e:~~~~~~i:n # 9eo <br /> <br />****************************************** <br /> <br />PLUMBER <br /> <br />MECHANIC~L .,'_____ Company. [;,A) tl ,~~ NlE.IlYl1\-L OOAJl <br />~Oj~ V State Cert. or Regist. 4ft . <br />Signature ' City License Registration # ~~ <br />, ,**********~****************************** <br /> <br />Company <br />State Cert. or Regist. ff <br />City License Registration 4ft <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLICATION APPRDVED BY <br /> <br />* *** **** * ****::!r****** * *** * *** *** * * ** * * * 1< 1< <br /> <br />)1 ~(J . g./l~ <br /> <br />PERMIT OFFICER. <br />