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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S N~~\-\u.rO\~ f4\o~\Q.'S> <br /> <br />PHONE <br /> <br />J7 '(3-6o!/ <br /> <br />OWNER'S ADDRESS <br />JOB ADDRESS LCdA..:H).(\dA Lon~ 3 J2 0 ~ y <br />LEGAL DESCRIYfION: LOT(S) f <('" BLOCK SUBDIVISIONJAJA /"'.IALO uAAln <br />, 0 (f'c) <br />PARCEL I.D.' \ l.\ - cl.lo - d.. \ - O/{o - ~Q::).... (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair I Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: .Lsingle Fuaily <br /> <br />_M/F <br /> <br />_' of Units <br /> <br />LM/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />_Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br />BUILDING SIZE: .~ l\ <br /> <br />x ~O ,--5loD <br /> <br />Square Feet,~ Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ArrACH (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 />$ <br /> <br />\ <<1 \ () (;)C) <br />\ 'S 0 <br />\ -000 <br /> <br />Valua~~f Total Construction <br />AMP Service .' Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_ELECTRICAL <br /> <br />----1tECBANlCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br />.j <br /> <br />Other <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />FIliISBED FLOOR ELEVATIONS: <br /> <br />F'f . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />L <br />YES NO <br /> <br />****************************************** <br /> <br />Signature <br /> <br /> <br />CONTRACTOR SECTION <br /> <br />CO~Mff S~N~rSe ~O~~l~ <br />State Cert. or Regist. t '31.\ L.j <br />City License Registration , J 17 <br />***************************************** <br /> <br />v-- <br /> <br />BUILDER <br /> <br />RT.RCTRICIAN CO~ANY <br />~ I () 1\ 1\ State Cert. or egist. t <br />SianAture ~ ~.l.J\J...<<A, City License Registration' <br />****************************************** <br /> <br /> <br />PLUMBER ~/ L. Q CO~Mff S ~ N S <br />State Cert. or Regist. <br />Signature . ~ City License Registration . <br />****************************************** <br /> <br /> <br />v <br /> <br /> <br />...-- <br /> <br />. <br /> <br />IlEl2lAlllCAI, N. COIIPAIIY () \ h ',,, 4; r <br />-;JJ;~ ~ State Cert. or egist.' 0 <br />Signature. /7 City License Registration . <br />***********~****************************** <br /> <br /> <br />v-- <br /> <br />OTIIRR CO~Mff <br />State Cert. or Regist. t <br />Signature City License Registration t <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />