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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />171\ f ~ /(1 <br />LfO' ~A <br /> <br />OWNER <br /> <br />~c4e gth(~J he <br /> <br />I f <br /> <br />"?d? :JC;/!e~ dlue <br />~(cfe.- .6w'/e-ivs ;z'c. <br />JOB LocATIo~.9 7 JJ-/?1e~~woCJ'# ;f),A/ve <br />11 <br /> <br />PHONE 9L//- '722.. -l?~Y"{) <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />I . 7- <br />LOT SIZE3~ X 110 AREA SQ. FT. J;oc'O <br />SUBDIVISION' /Y1e~c.uo(,'c..R S:ut.L.v/:Y~./l <br /> <br />PARCEL I. D. # 13 --Z&-2f - o/t'/() - 000 c 6 - (5/9-0 <br />WORK PROPOSED:~W Construction ----Addition ~lteration ____Repair ____Install <br /> <br />____Sign/Temp. <br />PROPOSED USE: ~le Family <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Demolish <br /> <br />_M/F <br /> <br />_# of Units <br /> <br />._M/H <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />----Restaurant & Health Department Approval <br />. II I <br />BUiLDiNG SIZE: n?g~t X 5-u, /30?? Square Fee t, <br /> <br />gl' <br /> <br />~ <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 />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br />.;2()O <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />I <br />~ECHANICAL <br /> <br />AMP Service <br /> <br />_Florida Power Cor~. <br /> <br />__W.R.E.C. <br /> <br />$ <br /> <br />1/ 'PoD. (JV <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br />TYPE OF CONSTRUCTION: ~ock _Frame _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />Signature <br /> <br /> <br />****************************************** flA,A <br />CONTRACTOR SECT~N /J" / . )J ( , cJVr- . <br />CompallY r~ OlUibi2/'..f ..fA C. <br />State Cert. 0 Regist. # ICAeOqg97~ <br />City License Registration # I? ? <br />************************************ <br /> <br />. ~ companyeClJlr.;- Y'; r~ s-vS <br />;;I;' it ~ State Cert. or Regist. II E'R../.7:J"- <br />Si!:!:nature ' ., City License Registration iF J 77'1 <br />r ~ ****** *********************************** <br /> <br />/ <br /> <br />PLUMBER <br /> <br />Signature ~e <br />.f, <br /> <br />"- j <br />~ .. <br /> <br />,\__.,' ~ \ / I <br />r~ Company t..\6u JJ I .s L1 l ~ t ~ <) <br />State Cert. or Regist. # t) b '8-/ <br />ltJ,~ City License Registration iF /9(;)'0 <br />****************************************** <br /> <br />/ <br /> <br />, Signature <br /> <br />v~'~ <br /> <br />Company [l. t::. f\.. e t-\- e. <br />State Cert. or Regist. <br />City License Registration <br />****************************************** <br /> <br /> <br />~/ <br /> <br />MECHANICAL <br /> <br />Company <br />State Cert. or Regist. # <br />/ City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />