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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S N~fY)()Y\YD't I L:i1(1)Y<"'VLCu <br /> <br />OWNER'S ADDRESS <br /> <br />fon\l . <br />Sri Yn~ <br /> <br />\4% S'tre-d- <br /> <br />PHONE A \?-.)-rts. D4/1 <br />2~6ll1~) r-:-L ~354-0 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. # <br /> <br />/)2. "'2-1., -7_\. DD2A - DDbDn.. 1)08'0 <br /> <br />(OBTAIN FROK PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ~- Repair ____Install <br /> <br />____Sign <br /> <br />____Kove <br /> <br />____Deaolish <br /> <br />PROPOSED USE: -L,Single FaBtily <br /> <br />____KIF <br /> <br />____, of Units _K/H <br /> <br />____~ercial <br /> <br />____Indust. <br /> <br />____Swill. Pool _Other <br /> <br />____Restaurant Ii Health Department Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />8n\ ~ l~ Kit" - PJ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />\ ~ IlL <~ ~ <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 />$ II ':S ~ It. 2> l6 <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 />____MECllANIGAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />____PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block ____FrOle ____Steel <br /> <br />Other <br /> <br />FIIUSHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />RT.RCTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />SiRnllture <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 # <br />*************~**************************** <br /> <br />Signature <br /> <br />omRR <br /> <br />Signature <br /> <br />COMPANy_M'1 \]dV" Cm,~1tUd\ o~ ' I ~ ~ <br />State Cert. or Regist. , (r I b S 7 " <br />I City License Registration" 31 <br />*****-**************************111'*'******_** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />