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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME <br /> <br />C,</SS#flVnLI4 <br /> <br />~oo,e~ <br /> <br />PHONE I 7.8>0 - /06'7 <br /> <br />OWNER'S ADDRESS S- 7 l :1 <br /> <br />/8T~ ,5r <br /> <br />JOB ADDRESS .5 /Q ~ 1 <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL I.D.t / / - 26 - 2/ - 00 Iii - 05'000 - 0070 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ---J\1teration _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 />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: II\/.s T A / / <br /> <br />1/c <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 REQUIRED 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 Serv'ice <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-'lECBANICAL <br /> <br />$ /So 0 . D C <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUCTIOR: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIRISBED FLOOR ELEVATIORS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BUTT .Dm <br /> <br />COKPARY <br />State Cert. or Regist. t <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAR <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />****************************************** <br /> <br />SignAture <br /> <br />PLUMBER <br /> <br />COMPARY <br />State Cert. or Regist. t <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />.. <br /> <br />Signature <br /> <br />COMPARY ~,q H te (r ",oR o~ A ^"" ~ '''$ .e.1/~ <br />~.L!t. / State Cert. or Regist. f C ACo'l~"f yS> <br />. a.A----- City License Registration t <br />****************************************** <br /> <br />MECHANICAL <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />