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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />-11; '- <br />fJ _I.D Yh <br />CA~;y/ . <br /> <br />OWNER'S NAKE -:sa IVtt.S M ~ f v,' V\ <br />OWNER · S ADDRESS G:, l() l r e.~ ( L ~ .. <br />JOB ADDRESS d ~ <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION 0 ~ \Ls I tk... <br />PARCEL LD.' c2-J.-fo-LI-ocl..C- C:03.o0-DO) D (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />PHONE 7ff..I:J ~~ O~ <br />2-1 H-l U '::> 8-( 3> 35l..{ \:) <br />t <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration -LRepair _Install <br /> _Sign _Hove _Deaolish <br /> . LM/H <br />PROPOSED USE: _Single FOlily _H/F _' of Units <br /> _eo..ercial _Indust. _Swta. Pool ___Other <br /> <br />____Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: A.\tAr\I\:r\~M e.oc f=--oJt/L N\0b~\e ~fl'\5L <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 />.+BUlLDING <br /> <br />$ Il{ 00 . D () <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'J"RlCAL <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 COBSTRUC'l'ION: _Block _FrOle _Steel <br /> <br />Other <br /> <br />FlNISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />Signature ______ <.:- <br /> <br />~1'1 <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY AJU(A.v\~cP {\tobl'~ t\vr'NL~ j~..s <br />State Cert. or Regist.' CE-C- 033 It <br />City License Registration' .:.5 '1 r <br />****************************************** <br /> <br />BUTT.DER <br /> <br />F.1.RC'l'RICIAN <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />SilmAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />OTIIRR <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 />