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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER I S NAME Jo 'f ( J.. C 117 CIo.t t:- <br />OWNER'S ADDRESS 5/33/ Rv.)/{.. c1y1- &. <br />JOB ADDRESS 58'SI c;;.e(~"Il.).tejAfL <br /> <br />PHONE >~...,~ 3r <br />C:~4rt/"/6 ~ I <br />C+ 2';IJAy;tA; IiI <br />4. h Jy /- W [J;J ~ /1M fl.J..l1V <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL I.D.# /0.. 2,& ..., ZI- (JllO-OO()o<.J- C)S-fd 0 <br /> <br />WORK PROPOSED: ~Construction _Addition Alteration _Repair Install <br /> - <br /> _Sign Move Demolish <br />PROPOSED USE: ~e Family _M/F - I of Units _M/H <br /> _Commercial Indust. _Swim. Pool Other <br /> <br />_Restaurant & Health Department Approval <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 REQUESTED <br /> <br />_BUILDING <br />_ELECTRICAL <br />_MECHANICAL <br />PLUMBING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />Florida Power Corp. <br /> <br />~E.C. <br /> <br />AMP Service <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 /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />F'l' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? ~ <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER ~ COMPANY LJ .~.;JG-iMIJ,J..J <br />J{) 0 State Cert. or Regist. I <br />Signature .1 City License Registration I <br />****************************************** <br /> <br />COMPANY GYm h.....i\..(f.~ / SI-/\.uJ' \: (- <br />State Cert. or Regist. I OOtb17YT <br />Ci ty License Registration I /;] 0 b <br />****************************************** <br /> <br />C. -k A <br />..., ~. ... ~ <br />'I\J~ U v I v-V ./ .v c.., <br />o 0'1 r) 8'V.( " <br />Lf <br /> <br />ELECTRICIAN <br /> <br />PLUMBER <br /> <br /> <br />Signature <br /> <br />COMPANY CAi4IlA~iJ.A Plu.n,{'l' <br />State Cert. or R gist. I <br />Ci ty License Registration # J as- <br />************************************* <br /> <br />MECHANICAL~~ COMPANY t!; l\JSl-i Cf-AJ I(~^{.} I <br />State Cert. or R gist. I 005'1/1..- <br />Signature.. ~~ Ci ty License Registration # ") I <br />** ************************************** <br /> <br />OTHER /!;.Y tf COMPANY 6JRJVI'V ~J~ {~9. <br />'..... '\, , State Cert. or Regist. II Dc) yb Z V <br />Signature C1 ty License Registration I ? 0 <br />. *******~******************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />