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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />4A~ <br />~/d- <br /> <br />OWNER'S NAME <br /> <br />-'SDhN <br /> <br />OWNER'S ADDRESS <br /> <br />5P.>1~ <br /> <br />A..I.I.n I ~ ^^-..J M~ R;€.M.IlJ~E:.. <br />I <br />IO~ sJ. 2G~"yV--bdI~ <br /> <br />PHONE <br /> <br />7 g~. IlldS" <br /> <br />JOB ADDRESS <br /> <br />~<;.AN\E. <br /> <br />3}Lj ~r <br />LEGAL DESCRIPTION: LOT (S) _ .. :.J. BLOCK .::J v SUBDIVISION (1.0. Z. . <br />. <br /> <br />PARCEL I.D..--1l-~to-~l - 101)10 - O,~OO -OOc3o (OBTAIN FROK PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction ~ition ---^lteration _Repair _Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_DeIIOlish <br /> <br />PROPOSED USE: LSingle Faaily <br /> <br />_KIF <br /> <br />_' of Units _K/H <br /> <br />_eo..ercial <br /> <br />_Indust, <br /> <br />_Swia, Pool _Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />DESCRIPTION OF WORK: B~o ~flnM.. ~' rAJoA;ly T{DDAA A..~r\,timJ. <br />, , , <br />BUILDING SIZE: l~ x3t- I 4.3~ Square Feet, 9'l Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS, <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />/41 nnn <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />V Florida Power Corp. <br /> <br />W.R.E,C. <br /> <br />-.JIECllARICAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLutmING <br /> <br />GAS <br />/Block <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF GONSTRUcnON: <br /> <br />_Fraae _Steel <br /> <br />Other <br /> <br />FIRISBED FLOOR ELEVATIONS: <br /> <br />F'l' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />L <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BIITI.D'ER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br /> <br />=IAR ~/2 COMPANY ~ ~ <br />' /) /} State Cert. or Regist, ## E Jl!L <br />e ~ U,; ~ . City License Registration' :J.a ~ <br />( ****************************************** <br /> <br /> <br /> <br /> <br />/ <br /> <br />PLutmER <br /> <br />~/A <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br />c" '5 <br />J. COIlPAHY:;;>" ff,v V . <br />kz State Cert, or Regist.' ~".," I' n / ~ C/" I <br />~ ~ City License Registration f :10 {, <br />******* ********************************** <br /> <br />COMPANY CA.l/il./ Cad!1i)q. <br />State Cert" or Regist, , <br />City License Registration # <br />****************************************** <br />'\ <br /> <br />Signature <br /> <br />Signature <br /> <br />A-0 <br /> <br />/ <br /> <br />MECHANICAL <br /> <br />OTRRR <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER, <br />