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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHlLLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME <br /> <br />f.e,;n <br /> <br />A/~'1/J (t.ltI"J <br /> <br />/It'/ ~ft:..~n(JJPHONE <br />/ <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />tS-/7 <br /> <br />~rll <br /> <br />/(j'/e <br /> <br />. <br /> <br />.J)r <br />~ <br /> <br />LEGAL DESCRIPTION: LOT(S) ('f~ BLOCK SUBDIVISION ..>)/~'l' d'4'Lr <br />PARCEL I.D.' ;-a6,-~/ - ()1,;)O-l)tJotJt)- tJR~tJ (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED: ~ew Construction _Addition ----..Alteration ~epair _Install <br /> <br />_Sign <br /> <br />---.Move <br /> <br />~eJIOlish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />---.MI F <br /> <br />_, of Units <br />/'" Swia. Pool <br /> <br />---.MIB <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Other <br /> <br />_Restaurant & Health Depar~ent Approval <br />DESCRIPTION OF WORK: S"','IJ,;';"~ A,l)/ C"fl.f/rYCJ;O}) <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 FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUlLDIHG <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 />_PLlJHBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br />J'lflt",,,,,nfj "/other <br />/ <br /> <br />TYPE OF CONSTRUcnON: _Block <br /> <br />_Fraae _Steel <br /> <br />FINISHED FLOOR ELEVAnONS: FT . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />./. <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BQJLIlIlR COIIPANY ;';'114-", .:T /1,,//At'ry ~ <br />/./,//~,..// ~ State Cert. or Regist.' CP~~ 6lf6 <br />Signature ~~ ..b?- ~ City License Registration' . ?~ <br />********'*;. *** ****************** *** ***** <br /> <br />~/J ~/7 COMPANY ()"'/4/1 EJ~(~,' <br /> <br />- Jl it~ ~V' f.?- ~~~\~:';e O~e:::~:~~i:" . <br /> <br />( ** *************************************** <br /> <br /> <br />..-- ~ <br />PL~ER :' COMPANY /AI/;''t;n J Filnllrl't ' r. <br />1./ '/# .:#- -/// ../ State Cert. or Regist. , C,iO d. If,v'h <br />Signature rt/~ ~ ~ <f7 City License Registration' ,~S <br />********~~****************************** <br /> <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />*************************************.**** <br /> <br />Signature <br /> <br />llTIIRR COIIPANY {AI;) 1;"", .:r F;"~. en" ~ <br />.~ ./ # _ ./ State Cert. or Regist. 'c c6 5"< 6 ~ <br />Signature /j. ~ City License Registration , <br />~ ******** . ..**.************************** <br /> <br />APPLICAnOR APPRllVED BY 'f1"'AI~)0 ,;;,,-1cJ PBIlIIIT OFFICER. <br />