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<br />APPLICATION FOR PERl'IIT
<br />CITY OF ZEPHYRHILLS
<br />BUILDING DEPARTMENT
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<br />A~~LICAN; & M. 1\-",) . COI\)S-\.c<:.u.e.~ ()tQ J ~ "'~
<br />ADD~ESS3"l~~S ~. e. E,4 '\N - ?(7 phye.bd.L~__PIl0NI::" <e>z... o~s-
<br />OWNER ""WA-YNe ~ ~~t)A ~t<:\c.s.. __
<br />JOB LOCATION 4<o~ """Y'S-\-~I~ P(C\~ LOT SlZECcO~ AREA SQ,FT. G,6()t)
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<br />LEGAL DESCRIPTION: LOT(S)
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<br />BLOCK
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<br />SUBDIVISION
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<br />PARCEL 1. D, ii~ 6 .~ <.o'~ \ - 6ltoD -a::x:>tY) - 0170
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<br />WORK PROPOSED:____NewConstruction ..2L.Addition X Alteration ____Repair ____Insta.Ll
<br /> _Sign/Temp. ____Sign _Move ____Demo I is 1:
<br />PROPOSED, USE: ..J:J.-Single Family _M/F _II of Uni ts ,_M/H
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<br /> _Commercial _Indust. _Swim, Pool Other '.
<br />~ _Restaurant & Health Department Approval
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<br />BUILDING SIZE: \S X~O I .~OO Square Fee t, 8~ Heigllc
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<br />RESIDENTIAL: '. ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FOR.'1S,"'"
<br />COMMERCIAL: ATTACH (3)5ET5 OF BUILDING PLANS & (1) SET ENERGY FOR~IS, ,',*
<br />**COPY OF CONTRACT REQUIRED.
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<br />~LDING
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<br />~~, CTRICAL
<br />v:~~
<br />_MECHANICAL
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<br />PERMITS REOUESTED
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<br />$
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<br />",5\ DOt>
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<br />Valuation of Total Construction
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<br />::1~
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<br />AMP Service
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<br />Florida Power Corp.
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<br />_\~,R,E.C,
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<br />$
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<br />Valuation of Mechanical Installation
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<br />__PLUMBING
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<br />GAS
<br />-6loCk
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<br />ROOFING
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<br />SPECIALTY
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<br />TYPE OF CONSTRUCTION:
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<br />_Frame _Steel
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<br />,Other
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<br />FliNI.SHED FLOOR ELEVATIONS: . FT,
<br />J.." \
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<br />**********************************~*******
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<br />, CONTRACTOE SEC~ON
<br />BUnnER; ," " , Company ljMA:t\J CbNS.~~c..-\-iOI\) ~f\)'
<br />~~ State Cert. or Regist. !I CI!c-035\34
<br />Signa.tu .",. '.' '0-.---- City License Registration;1 F35'
<br />. " .. . HU......"*....*u..*.......**,,.,,,,,,,,,,,,
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<br />EI FeTRrer AN- . Company MoIL~,;:) G- \eci-e~~
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<br />'t-1' State Cert. or Regist, II
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<br />Si"oature 'Lt9 ~~ City License Registration ;,1 _4l
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<br />PLUMBFR ~ J A- Company
<br />rH' State Cert. or Regist. ;!
<br />;:.'.Signature City License Registration 'I
<br />,t,1 , " '" * * * * * '* * * *' '* * '* * '" * * * -1:-1: '* ,*;/r * -It -I< .... -I, * * '* it -It ,'t " ,', ,', * ,I " ,'t ,',
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<br />~ MECijANTCAL~ ~~:~:n~er ~~~~:~iS~~ 4 e,A~~4,3<'\'t8
<br />: Slgnature>~m"w""..;~~~,~:~;~~;;.~;,~::~::~;:~~ '1- !i;i(') '-l&j 'IF;-
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<br />~i:;::O,T H F R
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<br />:\~:::Signa ture
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<br />Company
<br />State Cert. or Regist, 0
<br />City License Registration #
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<br />~ APPLICATION APPROVED BY
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<br />****'***'****'***'*****'***********************
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<br />,(.',
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<br />PER~lIT OFFICER.
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