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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />6..JJ V \ Rb,uMEAJT:A-LUD,vtRA <L'rt)~ <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />76j t' <br /> <br />r23f)~ <br /> <br />OWNER rv1..a ~ y Si:em /Ht) <br />JOB LOCATION S{p;}. <--I /J1 t f!Or<,! t.r.. LOT SIZIL-X <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br /> <br />AREA SQ. FT. <br /> <br />PARCEL 1. D. ~~ <br />WORK PROPOSED:____New Construction ----Addition ~lteration ~epair ____Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />_Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____~~ of Units <br /> <br />.-M/H <br /> <br />____Commercial <br /> <br />____Indust. <br /> <br />____Swim. Pool <br /> <br />Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING 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 FORMS.** <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 /> <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: FT. <br /> <br />****************************************** <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br /> <br />Company f~l<mfl1J S0.\~~ rE~ IIU~ <br />State Cert. or Regist. ~~ ' C) a? <br />ity License Registration # <br />****************************************** <br /> <br />( . <br /> <br />PLUMBER <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br />Company !3o //:Cft! Dl:!Lm EjfJfI!f ~7:- <br />State Cert. or Regist. # () ;;2. 9 ~ <br />y License Registration # 'IV <br />****************************************** <br /> <br />OTHER <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br /> <br />... <br />