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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE f)1''''N~.v jfJO.s.5~ .l'1/1/cA ~A//o ~ PHONE <br />OWNER'S ADDRESS "1"1 t - 'I~2 ~- S/6JO - '/t;:J~ /J /o<;.s,,~ II/IN/ <br /> <br />?g-8'"-- DOO 7 <br />.2t!!';// /Z J3S'// <br />, <br /> <br />JOB ADDRESS <br /> <br />5"1?m~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration '-"x"'Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />~M/F <br /> <br />_' of Units _M/H <br /> <br />_Comaercial <br /> <br />_Indust. <br /> <br />_Swim. Pool __Other <br /> <br />_Restaurant & Health DeparbBent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />C)"OO 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 />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ ~S30~ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />MIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CHABICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />)( ROOFING <br />, <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCfION: _Block -4-.FrUle _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA'? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration , <br />****************************************** <br /> <br />Sianature <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />*********************************** <br /> <br />Signature <br /> <br />OTRF.R <br /> <br />COMPANY %w~/!; Jf'&Jor-:'?;7 ;~4'.v ~c-r/ <br />State Cert. or Regist.......' "fc OO~S.>(';- <br />City License Registration' ggO <br />****************************************** <br /> <br />Signature <br /> <br />PERMIT OFFICER. <br />