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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT /1-1cv11 ~ :5(c:;-N +-A-GuN //'1 (?- Qo, I tY c ,/ pI< IS Cf"uA Q, '7ffM14u <br />/ 7::.tt, 3 ~':(.2.. ( ) <br />ADDRESS &/070 I g A-i/E NORrT-f (!/.Mfi--Wt9-7~ PHONE(8'/~ 573 ---7707 <br /> <br />OWNER...f'4.s COU'f-.(f /HJro P~7~ lIVe. J Ro. BDX ??o'K'o, LA-I<EjA-N/LAA-33 '8>W" <br />DfS c.oUN7 A-u7<!> 'r9-I?-7S STo~'t.E. 0b-37 4~ r <br />JOB LOCATION ~ ,LU. c.of2..1Ve12- OS3ot;! 12'Tfffit/€. LOT SIZE_X AREA SQ. FT. <br />-::::z~ fllu-S, <br />LEGAL DESCRIPTION: LOT(S) /:23~:"'~b BLOCK ,-~SUBDIVISIONC../7Y OF ;ze;~fI'I~/-I/2G.s;, <br />LoTS ~~r3 ~ Ij-::2b-':::<(-oCJ/o -S6>oO -- 00 ~ <br />PARCEL I. D .l~ Lo'r..s .3/ 4/ r <>-;7 II ,- d (:. -.,;:) 1- 00 /0 - oS'i?'oa .- 0 0 ~o -t <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ~ <br /> <br />____Sign/Temp. <br /> <br />_Move <br /> <br />____Demolish <br /> <br />PR6fa3EV USE: ____Single Family <br /> <br />aomme~ <br /> <br />____M/F <br /> <br />____# of Units <br /> <br />_____M / H <br /> <br />____Indust. <br /> <br />____Swim. Pool <br /> <br />Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />.' ~ <br /> <br />t)~, $~~ ~i ,~J.S. S/~~ <br /> <br />v ~ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.H <br />**COPY OF CONTRACT REQUIRED. <br /> <br />L SIMS <br />____BUILDING <br /> <br />$ <br /> <br />PERMITS REOUESTED <br />/ {, .'7.2/, ~ Valuation of Total <br />( , <br />AMP Service <br /> <br />Construction <br /> <br />____ELECTRICAL <br />____MtCHANICAL <br /> <br />______Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />____PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />--- <br />~ Other <br />-:ST~/ /fL-VPJIA(VI'Y1 f- <br />:pUE-)< I G-L/i.S , <br /> <br />TYPE OF CONSTRUCTION: ____Block ____Frame ____Steel <br /> <br />Signature <br /> <br />****************************************** . --rt-le)/J1.A-.r Jib Ir: <br />CONTRACTOR SECTION pt<, (S C/ t....LA &- ~ ' ~ cn /4 <br />Company ~mM S(G/'I 7 ~:UIVtW'G=! CO- (fie.. <br />State Cert. or Regist. # ~'c;;: cocC)o~ <br />City License Registration # j"" /~? 6 <br />****************************************** ~ " <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />ET.ECTRICIAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />PLUMRER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State'Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br /> <br />I.. 'I 'J <br /> <br />~~ <br />