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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />t <br />~(q <br />~rr <br /> <br />? <i-~ - /0 t tf " <br /> <br />OWNER'S NAKE <br /> <br />fYJ f+ Tt::: S-r I c <br /> <br />{)f+ Ie ~ <br /> <br />PHONE <br /> <br />OWNER'S ADDRESS <br />JOB ADDRESS --S t 2- 7 <br /> <br />L/H(L(il- <br /> <br />V A-U" F '-( <br /> <br />(5 '-VI) <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL 1.D.# '2--Lf- '2fo - 1--( 19000 - 00100- '3 0 (OBTAIN FROK PROPERTY TAX NQTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _A1teration _Repair _Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_DeJIOlish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_KIF <br /> <br />_' of Units _K/H <br /> <br />_<=<-ercial <br /> <br />_Indust. <br /> <br />_Swim. Pool _Other <br /> <br />_Restaurant 5: Hea1th Departaent Approval <br /> <br />DESCRIPTION OF WORK: ~ C rlll.-/tJ!t--r <br /> <br />, <br />( <br /> <br />t/ -I&{)~ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />L-o-r J D <br /> <br />RESIDENTIAL : <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS 5: (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS 5: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ 4100.00 <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 />-IfECIIANlCAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDlISHED FLOOR ELEVAnONS: <br /> <br />Yr. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />*******************.***..*****.*********.* <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br />Signature .:bt. <br /> <br />COMPANY <br />~ State Cert. or Regist. # <br />~- City License Registration t <br />.*****************.***********.*.********* <br /> <br />..J-~ <br /> <br />RJ.RCTRICIAN COMPANY <br />State Cert. or Regist. t <br />SianAture City License Registration # <br />************.*.*.***.****.*******.*****.** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration . <br />*********..***********************.*..**.* <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration # <br />***.*.*************...*********.****.....* <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration # <br />***.*.****.**..*.****.**.****.*.********** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER, <br />