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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />... '.. <br /> <br />OWNER'S NAKE 'TA /}/Y) /Y , C-- , ~ -I ~ ~ PHONE ;> fi'}- '} jl ,F 6 <br />OWNER'S ADDRESS ~ 5' q I? Il.Jr{ 5 T Zj~h (/-1'/ /t; p-t,. <br />JOB ADDRESS (.,/1-, ( /TS 11'6C?v^t..- <br />, <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK SUBDIVISION <br /> <br />- 0 3> 51} () - tl'jlt(OBTAIN FROM PROPERTY TAX NOTICE) <br />/' <br />--0iepair _Install <br /> <br />PARCEL 1. D.' <br /> <br />//-I-b- 'J-I-OO/{) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration <br /> <br />_Sign <br /> <br />---1Iove <br /> <br />_DeJIOlish <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 />_Swim. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: tf .e /JJ'rc G (i ~ ",. t- ~ C/ ~ j? AI/- C /.7,.,/ .s Y 51t!..., {6.y? l/-Jo'} / ) <br />, , I 1../ <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 />---,.ELECl'RICAL <br />~KECHAlUCAI. <br /> <br />AKP Service <br /> <br />$ :;'(1 OO~ ~ <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <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 />FINISHED 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 />BUTI.DER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.....................**.***.**..*.***...*. <br /> <br />Signature <br /> <br />RT .RCl'RICIAN <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration . <br />..............*...*.*.....*...*....*....*. <br /> <br />SiQOAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />........**...*.****.******....*****.*.*... <br /> <br />Signature <br /> <br />, \ { <br />KECHANICAL /: / COMPANY IJ/}/.JV'~ /I "t? "hi'1, } <br />/;" ~ i(T~ State Cert. or Regist. t c: <br />Signature /V'--"'~ ~. City License Registration' <br />...*...**..~**.*..***.........**.****...*. <br /> <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration , <br />...........***.***.*.**.*.....*.*.**..***. <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />