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<br />~ <br /> <br />APPLICATIO~ FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT ----A.-1/ 4/ <br /> <br />fJa .{ 1 c r <br />I f)t~ 5-:1. <br /> <br />S 0011"':. <br /> <br />PHONE 7 f3;1- .). 87 Y <br /> <br />ADDRESS ,. J I tj <br /> <br />OWNER <br /> <br />JOB LOCATION <br /> <br />S /..( ;'Y1 t. <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. ~F..:,--f J - 2. t - 2 / - t? /J J tJ - f C( J CJ ('J - tJ I (f I? <br /> <br />WORK PROPOSED:____New Construction ____Addition ~lteration ____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 />_# 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 />x <br /> <br />:.1 tJ I':JIJ <br /> <br />Square Feet,~ <br /> <br />- <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 />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />J/fttJ.(J(J <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: ~B10ck ____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <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 />OTHER <br />Signature J# ~- <br /> <br />Company ~1 m V J:)/ L '11/' . <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />APPLICATION APPROVED BY <br /> <br />~*********~************************** <br /> <br />.A'~ct ~ ~/)!)~r- .. : <br /> <br />. , <br /> <br />PERMIT OFFICER. <br /> <br />." <br /> <br />... .. <br /> <br />., <br /> <br />,~:;&II...;.:, ,. . j <br />