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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />1/ -77 <br />/-~ <br /> <br />OWNER'S ADDRESS <br /> <br />K/ c ifill<. )) <br />3((,3"0 <br />\-A;-r <br /> <br /><0 €/'f2 <br />C!hT-rVC~Y ~ <br />CJ 0 ffl~~'c.2) <br /> <br />PHONE <br /> <br />OWNER'S NAKE <br /> <br />JOB ADDRESS <br /> <br />;::> ;;'!;-"j /j/7 _. _ _ A-, _~~ <br />/ d/ ;J ~ ....>- C><- (.~ _~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />. <br /> <br />P~POSED~E: _Si~leF~i~ <br /> <br />_M/F <br /> <br />_, of Units _M/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />_Restaurant & Health Departaent Approval <br />'7J- /' /lJ S77f-Ll- .y47tlol oR- <br /> <br />10Yk) 1kE--RJjJ <br /> <br />b I/-if)) <br /> <br />BUILDING SIZE: <br /> <br />/0 xlO . <br /> <br />(IJ"tJ 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 />/:J <;0 . <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECllARICAL <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 />PDUSBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BUTI.DER <br /> <br />CONTRACTOR SECTION <br /> <br />~~~-,7 ~. JO"-:-7I-.L <br />>",_,;;~:,,":~...- .::;~~"" COMPANY 01 ~ <br />.... .>~,,_.~;;;::::;:;'''c~ .. ... ....~ State Cert. or Regist. , <br />~.~ .. . City License Registration' <br />c."...., .... ****************************************** <br /> <br />~-Ll/ 1(/ /fJ vI/' <br />?Il <br /> <br />SignatuJZe <br /> <br />F.T.RCTRICIAR COMPANY <br />State Cert. or Regist. , <br />SiDnAture City License Registration , <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration . <br />****************************************** <br /> <br />KECHANICAL COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration , <br />***********~****************************** <br /> <br />OTIIRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration t <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />