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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />JOB ADDRESS <br /> <br />If Ib(tC- '(A! <br />!Jtf d 'l <br />t:J II1f l <br /> <br />fl66Y <br />I t-ff<- '3 r <br /> <br />PHONE <br /> <br />Ir~'~ ~7( <br /> <br />OWNER'S NAME <br /> <br />OWNER'S ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL I.D.' II 02-(p 02-( OC)IO (j 5100 0'(;00 <br />WORK PROPOSED: ~ New Construction ____Addition _Alteration ____Repair ____Install <br /> <br />_Sign <br /> <br />Move <br /> <br />Demolish <br /> <br />PROPOSED USE: <br /> <br />Single Family <br /> <br />_M/F <br /> <br />_# of Units <br /> <br />~/H <br /> <br />Comercial <br /> <br />Indust. _Swim. Pool <br /> <br />Other <br /> <br />Restaurant &: Health Department Approval <br />BUILDING SIZE:lo X f~, k Flit> 5lfU 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 />lo5~ -bV <br /> <br />PERMITS REQUESTED <br /> <br />____BUILDING <br />ELECTRICAL <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 />____MECHANICAL <br />PLUMBING <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <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: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BUILDER <br /> <br />CONTRACTOR SECTIO:N <br /> <br />~ ~ COMPANY Su/llS7Jf7c. <br />State Cert. or Regist. # <br />' ,/I' ~ Ci ty License Registration # <br />****************************************** <br /> <br />/It. () if {/t/ d If <br />77 <br /> <br />Signature <br /> <br />ELECTRICIAN COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration # <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration # <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration # <br />****************************************** <br /> <br />OTHER COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration # <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />