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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME <br /> <br />~c6 <br /> <br />K e; ~t~ PL <br />11../l.R~,1U' PF~Y <br />y <br /> <br />rtWy S-Y Ct:...;T <br /> <br />PHONE <br /> <br />OWNER'S ADDRESS _ 5':;- () <br />JOB ADDRESS '7? ') () I <br /> <br />~Q ?Pt.1 Tt1'1-r /11'1- PL, <br />"7- f::;f'1t 7 tf.. 1-/' ~L.l- <br /> <br />- <br />r(. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' {))... !2.. G 21 00) 0 0 CloD () 0 00 (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction _Addition _Alteration V-;:epair _Install <br /> <br />_Sign <br /> <br />---"ove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br />~eo..ercial <br /> <br />_H/F <br /> <br />_' of Units _M/H <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: ~~J~ OLA-f (2) :; ..7~ <br /> <br />/1 C-, <br /> <br />~ <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 />PROPERTY SURVEY REQtnRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service Florida Power Corp. <br />$ ~!J -rJ 0 \ (J 0 Valuation of Mechanical Installation <br /> <br />W.R.E.C. <br /> <br />_MECHAIIICAL <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _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 />Signature <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />BUILDER <br /> <br />SiQllAture <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />****************************************** <br />\ <br /> <br />F.l.F.CTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />PLUMBER. <br /> <br />Signature <br /> <br />MECHANICAL <br />Signature /5; <br /> <br />___ COMPANY ftPVIhVl' 01) tf7 ~c d- Ik/- <br />-z:- ~ State Cert. or Regist. t I' fTe- 0.7-6 i .2..0 <br />L- City License Registration' 17~ 9 <br />******* ********************************** . / <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration t <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />