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<br />APPLICATION FOR PERMIT <br />CITY OF Z~PHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT c W~\,)\ ~W ~<ec\.\ Q.c:... \.. ('1s <br />ADDRESS ~ 335 G-c...\.\.. ~\\) d""* :L 2. ~\ \..\~ PHON <br />OWNER '6uJ ~ (), t. ~ ~ U-~ \ ~c... \.. '{\ f -\ S ?~ (-\ ~ E: Cs l, f <br />JOB LOCATIOh__ ~'lWb~ l"V\.<c.c\'I~c:.r.\. Ai\,s e."\ LOT SIZE X AREA SQ.FT. , ~ <br />LEGAL DESCRIPTION: LOT(S~.A..A.AR :2-- BLOCK - SUBDIVISIO~.A hA..A~) ~.D..f) <br />PARCEL I.D.~F ~ l\-~S-~l-D 006 -OcJDO -0060 <br />WORK PROPOSED:~New Construction ----Addition ____Alteration ~epair ____Install <br />____Sign/Temp. ____Sign ____Move ____Demolish <br /> <br /> <br />PROPOSED USE: ____Single Family ____M/F ____t~ of Uni ts .~/H <br /> f-commercial ____Indust. ____Swim. Pool Other <br /> ~estaurant & Health Department Approval <br />BUILDING SIZE: X Square Feet, 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 REQUlRED. <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 />CONTRACTOR SECTION (\ rr ~ <br />Company \ ~ 0. \.> d.~ ~\. "--0. .r ~ C' . <br />State Cert. or Regist. C-OI{}G~~ <br />Signature City License Registration # <br />************************************~***** <br /> <br /> <br />::=:: :;:JitJAit- ~~~~~~~:~~e o~~:~;~:;~::~ tI=-/7 3 <br /> <br />....~........................... <br /> <br /> <br /> <br />Signature <br /> <br /> <br />Company ~o.ik 0 ~ 'L. \-t: <br />State Cert. or gist. # <br />City License Registration <br />**************************** <br /> <br />~l~~~~~~ <br />C- ~O:) Y <br />4~ <br /> <br />MECHANICAL <br />Signature Y <br /> <br />Company giOlI,e is ~().;;-t,y~ G,f".t...~ <br />_) /-<--. State Cert. or Regist~ # CtllcoJ/3fjy <br />;7 ~,~ ' City License Registration # <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-u~ <br /> <br />PERMIT OFFICER. <br />