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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPAR7MENT <br /> <br />OWNER <br /> <br />~~4.Yl <br />~Q~ <br /> <br />bDl.QAAd~ ll)ar~cu.s.e <br />L,(< sLi ~-\ L,\h.JL,PHONE <br />b()\~.er <br />:so.. yY\ ~ <br /> <br />l~~ "~~VCJ <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />JOB LOCATION <br /> <br />LOT SIZE_X <br /> <br />AREA SQ.FT, <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D,# <br /> <br />o d. - a ~ . d l - GO \ 0 ... 0 S ~oO - 00 \ ~ <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />_Move <br /> <br />____Demolish <br /> <br />____Commercial <br /> <br />____Indust, <br /> <br />____Swim. Pool <br /> <br />_____M / H <br />~ "^-nt~b-Other <br /> <br />PROPOSED USE: ____Single Family <br /> <br />_M/F <br /> <br />____# of Units <br /> <br />~ <br /> <br />_Restaurant & Health Department Approval <br /> <br />Bu:hD"fNG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~S,** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />.I <br />____MECHANICAL $ <br /> <br />AMP Service <br /> <br />Florida Power Corp, <br /> <br />_W.R.E,C. <br /> <br />Valuation of Mechanical Installation <br />GAS ~ROOFING SPECIALTY <br />____Block _Frame _Steel Other <br /> <br />_PLUMBING <br /> <br />TYPE OF CONSTRUCTION: <br /> <br />FINISHED FLOOR ELEVATIONS: FT, <br /> <br />****************************************** <br /> <br />Signature <br /> <br />~ CO~T~~~~n~ECTTON <br /> <br />State Cert. or Regist. # <br />City License Registration 4F <br />/ ****************************************** <br /> <br />BUILDER <br /> <br />:::::::AN <br /> <br />:~ Company <br />State Cert. or Regist. # <br /> <br />- - ***..****........~~~~.;~;:~~:*~:~~~~~:~~~~ iI <br /> <br />X- <br /> <br /> <br /> <br />X Company <br />State Cert. or Regist. 0 <br />Signature / City Lice'nse Registration ,~ <br />~c{)~ . * * * * * 1: 1:* * * *** ** ** *** ** * * ** * of: * of:,~ * ,', * * *1:'~ 1: 1: ,', 1: <br /> <br />OTHER~ ~ Company ~ r~1zG <br /> <br />-.' ~/ .' State Cert. or Regis, # ~ I~~ <br />Signature -- L ~ City License Registration iF 4.2 <br />-- ~ - <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. iF <br />City License Registration # <br />**********************m******************* <br /> <br />PLUMBER <br /> <br />MECHANICAl <br /> <br />****************************************** <br /> <br />APPLICATION AJ;>PRQVED BY <br /> <br />PERMIT OFFICER, <br />