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<br />/l~/P?C 4/~ <br />IJ- 'j -. 9.J <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT ~\\t \~ 1\llJl1)~V)tJVY) <br /> <br />::::55 ~;l; 1:~;~f~~ <br />JOB LOCATION rtf:? _~ f<oIl/lA:') <br />fA) I ~"'f( V'b ttft'l'tiy- k <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PHONE <br /> <br />. 78't~ - '171 ~ <br /> <br />LOT SIZE~X <br /> <br />AR.EA SQ. FT. <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.lF <br /> <br /> <br />____Alteration ____Repair ____Install <br /> <br />WORK PROPOSED:____New Construction <br /> <br />~/Temp. <br />PROPOSED USE: Single Family <br /> <br />____Sign <br /> <br />_Move <br /> <br />_Demolish <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 />_Restaurant & Health Department Approval <br />, ,I <br />BUILDING SIZE: ~x :20 ' <br /> <br />:J.30 <br /> <br />Square Feet, <br /> <br />?f) If . <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (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 />~ILDING <br />-dECTRICAL <br />\ZHAN~CAL <br />LUMBING <br /> <br />$ <br /> <br />~f)O~' <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block ~ame ____Steel <br />FINISHED FLOOR ELEVATIONS: rOl' Im'. <br /> <br />Other <br /> <br /> <br />****************************************** <br />CONTRACTOR SECTIO~ <br />Company - Y <br />State Cert. or Regis . IF <br />City License Registration <br />****************************************** <br /> <br /> <br />Company ,he s .~- (!I~S <; <br />State Cert. or Regis t. IF C ~o 0 ~s-,/ 7 <br />Ci ty License Regis tration 4F / S ( <br />****************************************** <br /> <br />Signature <br /> <br />t:' f. "( t!J..t( /11b, lu G Company <br />(\1/_/1 ~ ~ ~ State Cert. or Regist. 4F ~ foe y(r:;y R" <br />,_ /[c:..~~ --1. / _ City License Registration IF 37 <br />i ****************************************** <br /> <br />Company <br />State Cert. or Regist. IF <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. IF <br />City License Registration IF <br /> <br />OTHER <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />