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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />tt,~~~%tl <br />t <br />PHONE 7 (r o~ /:1. 7 rY <br />J' ..e f'~p 71..) Jj f LJ J , r; :;r- L/ <br /> <br />...i3 .5 y{) <br /> <br />{...... ., ..... <br />OWNER t S NAKE . ,.) tt .'::;; 1'1 I rl. <br /> <br />OWNER t S ADDRESS <br /> <br />b I :S-O <br /> <br />JOB ADDRESS 6! i:) I- J } /(1 <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />( . <br /> <br />; / <br /> <br />/1' <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <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 />PROPOSED USE: _Single Fuaily <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 Department Approval <br /> <br />DESCRIPTION OF WORK: <br />BUILDING SIZE: I 7 <br /> <br />I' <br />X ?rJ , <br /> <br />'J{) <br /> <br />... <br />Square Feet. ,7 <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 />V');UILDING <br />~"U <br />-LL'WCTRlCAL <br /> <br />$ <br />$ to () f tJ 0 <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />NIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KECllAliIGAL . $ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF COHSTRUCTIOH: _Block _Fruae _Steel <br /> <br />Other <br /> <br />FlHISBED FLOOR ELEVATIOHS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRAC1:llII s~ <br /> <br />COMPANY .i~~OJJ7VA) <br />State Cert. or Regist. . <br />City License Registration , <br />..............*....*****..***..*********** <br /> <br />l;OMPANY ('1~ ~p 1.) <br />State Cert. or eg S . <br />City License Registration , <br />***.**.**********..**..*..**************** <br /> <br />BUILDER. <br />Signaturei/ <br /> <br />F.T.RC'f'RTC~ <br /> <br />---~---- <br /> <br />SiooJ!lture {/" <br /> <br />PLUMBER. <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration f <br />.***.**.********************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration f <br />****.*******~***********.******.*********. <br /> <br />Signature <br /> <br />OTRF.R <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration I <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />