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<br />APPLICATION FOR PERNlT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />if?- f- r tL" . <br />Ah 1/, /-./ tJY:J- /} -- 5S-- <br />(t' 78 / /j__C-/ <br /> <br />APPLICANT --.R Y N\1\-i\J QOY\l S..\-e.V-c....~6~ ) -:r.N CL <br />ADDRESS ~lSd..S s.e, ~ W - Zt"phytzhl\\<;' PHONE{52-052~ <br />OWNER _ ~ "1,0 ~.,. fYlf'''' l.::r" ""..::, \.! <:,N$,.C ,,:, . Q'15 /It/. V 4-ul; ~ (;J1 <br />JOB LOCATION bo,,", ~q.., - ~ c..CC:r'~~ #V\A-f))OIC... LOT SIZE~X \O~ AREA SQ. FT. ~O \ 4-- <br />LEGAL DESCRIPTION: LOT(S) q -, BLOCK SUBDIVISION ~<DQ,-.<:. Woo.Q <br /> <br />.. <br /> <br />PARCEL I, D . ~.' <br /> <br />\ D - d&. . :9- \' 0 \d.O.- 00000 - ocr, 0 <br /> <br />WORK PROPOSED:~New Construction ____Addition ____Alteration ____Repair ____Install <br /> <br />____Sign/Temp. <br />PROPOSED USE: ~Single Family <br /> <br />____Sign <br /> <br />_Move <br /> <br />____Demolisll <br /> <br />____M/F <br /> <br />____IF of Uni ts <br /> <br />,____M / H <br /> <br />____Commercial <br /> <br />____Indust, <br /> <br />____Swim. Pool <br /> <br />Other <br /> <br />} <br /> <br />____Restaurant & Health Department Approval <br /> <br />BU1LDING SIZE: 1ID~~, <br /> <br />lS~3 <br /> <br />Square Fee t , <br /> <br /><O( <br /> <br />Heigllt <br /> <br />RESIDENTIAL: <br />CmU1ERCIAL : <br /> <br />A TT ACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR.'1S.":: <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORNS. 1'* <br />**COPY OF CONTRACT REQUIRED, <br /> <br />~UILDING <br /> <br />PERMITS REOUESTED <br /> <br />$ 4<0,,00 Valuation of Total Construction <br />I <br />~OO AMP Service Florida Power Corp. <br /> <br />DO> <br />~o <br /> <br />.2s..--H.R.E.C. <br /> <br />____ELECTRICAL <br /> <br />"f <br />____MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />____PLl~BING GAS <br /> <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />ROOFING <br />~Frame ____Steel <br /> <br />Other <br /> <br />SPECIALTY <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT, BFE~ <br /> <br />****************************************** <br /> <br />Signature <br /> <br /> <br />CONTRACTOR SEC~ON <br />Company '-( M~ eo rvs-t-. -s: f0 . _ <br />State Cert. or Regist. if c..~(:-O 35l~<t- <br />City License Registration iF ?3 5'"" <br />***************************************** <br /> <br />v..J <br /> <br />ELECTRICIAN ~R..\~~-,:?",,~~)ts.. Company ~\.\~ ~\e(~~Q.. <br />/,) .J\ ..-f- State Cert. or Regist. # 6.'{LoC)\~~4~ <br />Signature 't)L~--- r- --.:~J~ City License Registration 1F 9, , <br />****************************************** <br /> <br />Signature <br /> <br /> <br />Company 4/h~ \) 11'111 e5 <br />State Cert. or egist! # <br />City License Registration # <br />****************~******************* <br /> <br />~/J/ b' <br />~O~? ~J1 <br />ICJIJ <br />- <br /> <br />Company BI\.~L'S GAS ~ A~ <br />State Cert, or Regist. i.! ~ Be> 3'\ 4-e:> <br />Signature City License Registration # ./if' 713 <br />****************************************** <br /> <br /> <br />OTHER Company <br />State Cert. or Regist. if <br />Signature City License Registration if <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br /> <br />