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<br />APPLICATION FOR PERMIT <br />CITY OF Z~PHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT 0 W \\J \) \ <t \..\J ~ ~c\.' \ Q..C4. \. r \s <br />ADDRESS '\ 3 3S G-Q.\'\' ~\ \) d""* "- 2 \(, \.\~ PHON <br />OWNER ~ ()u)~\J\ t.~ ~u-1 \ ~c:...\... 't\r-\s ?C((-\: 't\J ~cs hI f <br />JOB LOCATIOh-<o ?/1 ~O" 'M.,<c.J"I~c...\. Ai \s e.1 LOT SIZE X AREA SQ. FT. , ~ <br />LEGAL DESCRIPTION: LOT (S l.2..f2O~ ':2.-- BLOCK - SUBDIVIS IO~.A 'hA.A ~) ~.oJJ <br />PARCEL I.D.ti ~ ~-;2S-~l-D 006 -Oc.3DO -0 C60 <br />WORK PROPOSED:~New Construction ----Addition ____Alteration ~epair ____Install <br />____Sign/Temp. ____Sign ____Move ____Demolish <br /> <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____# of Units <br /> <br />.~/H <br /> <br />~commercial ____Indust. ____Swim. Pool <br /> <br />~estaurant & Health Department Approval <br /> <br />Other <br /> <br />BUILDING SIZE: <br /> <br />X <br /> <br />Square Feet, <br /> <br />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 /> <br />$ <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 ____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br /> <br />CONTRACTOR SECTION 0 \ ~ ~ <br />Company \ ~ 0. \..) d.~ ~\ . . J..: ..u C . <br />State Cert. or Regist. "-- Gj~ <br />City License Registration # <br /> <br /> <br />:::::::::~~..~~............:::::::.::....:....~..~.. <br /> <br />. - II State Cert. or Regist. #_ <br />. . ,..oJ.) City License Registration # #=-/73 <br />......... ............................... <br /> <br />Signature <br /> <br /> <br />Company ~o.ik 0 ~ 'L -\::.-\:: <br />State Cert. or gist. # <br />City License Registration <br />**************************** <br /> <br />~ l~~~: ~~ <br />L ~O:) .v <br /># <br /> <br />MECHANICAL <br />Signature Y <br /> <br />Company g ,e!.s ~I'- ~,y~ b,f"...e... <br />/ ./ ~ State Cert. or Regist. # CI4Co '.J ~ <br />71/ LJ ," . City License Registration ~~ <br />****************************************** <br /> <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />.*~*******~**~/*************************** <br />APPLICATION APPROVED BY ~(J ~.A4J-y..r- <br /> <br />PERMIT OFFICER. <br />