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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER t S ADDRESS <br /> <br />IS'"::> \0 -t m f'\ r r t 4., (\ h 4 vY'. <br />~q <0 3::;, C h c\ h <--e. y Rood <br />f <br /> <br />PHONE <br /> <br />OWNER t S NAME <br /> <br />~ -:s 'i <br /> <br />JOB ADDRESS <br /> <br />5Am~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />3~ <br /> <br />BWCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ~lteration _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 />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <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 />2s:;:..ELEcnuCAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />\Dv <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <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 />FDUSHED 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 />Signature <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />****************************************** <br /> <br />::.:::C~ ~~g;'h~ COMPANY ~ ~ r- ~ <br />, State Cert. or Regist. , F .r 17 t::) oot:? 6 I <br />City License Registration f 187 <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration f <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration t <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 />