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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />d --'1-77 <br /> <br />OWNER'S NAME <br /> <br />t~o.r Ie:,> LAYlada.y PHONE <br />39 ~ 3D cJ,Qy\(1 ~eJf 4<d <br />"--oi~ J.fLR ~eYQ\~ --{)oin+e., d,?Y7 /J!d~ <br /> <br />OWNER. , S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROK PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction vtddition _Alteration ---.Repair _Install <br /> _Sign ----,"ove _De.olish <br /> v~ingle . <br />PROPOSED USE : Faaily _M/F _' of Units _K/H <br /> _ec-ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health DeparbDent Approval <br />DESCRIPTION OF WORK: Gb~s ~M) vJQ?O iJpcl<.... <br />BUILDING SIZE: 3;Z X J d-.. . ~~'D1 Square Feet, '8( Height <br /> <br />RESIDERTlAL: <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 />LIK <br /> <br />bcnuCAL <br /> <br />PERMITS REOUESTED <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />NIP Service <br /> <br />Florida Power Corp. <br /> <br />N.R.E.C. <br /> <br />-"ECllARICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />PINISHED FLOOR ELEVAnONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />Signature <br /> <br />~ <br /> <br />YES NO <br />*****************************************1* 1)/1" 19J Y <br /> <br />~CTOI\ S8CTION · ~"" ~L:iI <br /> <br />J. COKPANY <br />, ) State Cert. or Regist. t ~ V' <br />LJ City License Registration t ~ 7 ':)... <br />******... *....*.............**......*..* ' .'}; <br />"; <br /> <br />BUILDER <br /> <br /> <br />COMPANY <br />State Cert. or Regist. . <br />ity License Registration t <br />.....******************....*.*.***** <br /> <br />1'10 <br /> <br />V"', <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration t <br />***********..*..**.****.....*.*.**..**.*** <br /> <br />IlECBARlCAL COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration . <br />****.**.**.~*****.******...*********..**** <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration t <br />.*.....*....**.***.*.*.*....**...*...*..*. <br /> <br />APPLICAnON APPROVED BY PERMIT OFFICER. <br />