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<br />APPLICATION FOR PERMIT <br />CITY OF ,ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />ADDRESS <br /> <br />E JU \J I ~C>>l \ M E-10'rA L QnIlSn~, f\c!")vR.:~, <br />~ 8 ~ 3 ..;20'''"''- ~ "\ <br /> <br />Nli2- ~ M~~~c~~~T ililIOG.:>€.kMAAJ <br /> <br />PHONE <br /> <br />7g'(- .::2833 <br /> <br />APPLICANT <br /> <br />OWNER <br /> <br />JOB LOCATION 68'S?:> Dl.O"'" ~\ <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 />/I ~h ,;J. I <br /> <br />DOlO <br /> <br />'0'-1&:>00 <br /> <br />DDbO <br /> <br />I-JORK PROPOSED: ____New Construction _Addition _Alteration ____Repair -XIns tall <br /> ____Sign/Temp. _Sign _~love ____Demolish <br />PROPOSED USE: _Single Family _M/F ____1f of Units ____M/H <br /> _Commercial _Indust. _Swim. Pool Other <br /> <br />~estaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet I <br /> <br />Height <br /> <br />R~SIDENTIAL: <br />COHMERCIAL : <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 FORNS. ** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PKRKITS REOUESTED <br /> <br />_BUILDING <br />---K-ELECTRICAL <br />~MECHANICAL <br /> <br />$ <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 />r:2~&.O, DO <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: <br /> <br />FT. <br /> <br />CONTRACTORS <br />Builder <br /> <br />Company <br /> <br />Signature City License Registration # <br />***************************************************************************************** <br />Electrician Company {;.t!R.ltlAAJ 5'i.5.TEI11S f-vr ..LI\JQ.. <br /> <br />Signature City License Registration 1f / ~ ( <br />*********************************** **************************************************** <br />Plumber Company <br /> <br /> <br />Signature City License Registration 1f <br />***************************************************************************************** <br />~lechanical Company ~,A)UI~DlJ1Y\EN-rAl, &~.Y'fkf\Q..lo~S. <br /> <br />City License Registration # 41~' <br />****************************************************** <br /> <br />Signature <br />**********************~*********** <br /> <br /> <br />Other <br /> <br />Company <br /> <br />Signature <br /> <br />City License Registration # <br /> <br />I Hereby certify that I have read and examined this application and know the same to be <br />true and correct. All provisions of law and o~dinances governing this type of work will be <br />complied with whether specified herein or not, the granting of a permit does not presume to <br />give authority to violate or cancel the provisions of any other state or local law <br />regulat' construction or erformance of construction. <br /> <br /> <br />8-.3/,-'13 <br /> <br />Date <br /> <br />t/?~4r~ ~'""-,,~ <br />Sign,ll~ of WIler <br /> <br />B/ 3/ 19~ Date <br />- 'signed by th <br /> <br />~~ <br /> <br /> <br />vner and notarized. <br />J'lotary Public, State of Florida <br />Robert Charles Ehrman, Jr. <br />My Commission Expires April 27. 1996 <br />Comm. No. CC 196771 <br />