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<br />:. <br /> <br />&dudul.' -VYltf~4JL ,'f~t5 ern 8 <br />APPLICATION FOR PERMIT /~ j I / ~-;-.!.. ~- _ a p; '~f rD <br />CITY OF ZEPHYRHILLS ".~ -b(1..U-~ -= d I I 10'-' ~ <br />BUILDING DEPARTMENT f(}Jr ,,/ <br /> <br />OWNER'S NAME <br /> <br />/' <br /> <br />Xu, 0 T7'ESc4! <br /><~ CZ 7 ~s- /fl- ~ <br />~ j/6/flC-tff([ s <br /> <br />PHONE <br /> <br />711.2. 1(; yrs- <br />,7yf -- 7-StJ~ <br /> <br />OWNER'S ADDRESS <br /> <br />11-1/ E.- <br />FL <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: <br />~tJ""""" <br />:~~!~ <br /> <br />WORK PROPOSED: <br /> <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />I - GO <br /> <br /> <br />?c!> <br /> <br />_Addition ____Alteration ____Repair ____Install <br /> <br />_Sign <br /> <br />Move <br /> <br />_Demolish <br /> <br />PROPOSED USE: l/'Single Family <br /> <br />_M/F _' of Units <br /> <br />~/H <br /> <br />Commercial <br /> <br />Indust. Swim. Pool <br /> <br />Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: JC6 X !7f , <br /> <br />(' A:e ?ot!--r- <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 /> <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 /> <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: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BUILDER <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY c5'd~S'~ <br />4:? //~ State Cert. or egist.' <br />'. K ~ Ci ty License Registration # <br />**************************************** <br /> <br />/i(,~ r/ tiff 'f/d'1' <br />77 <br />( <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 />