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<br />OWNER'S NAKE <br /> <br />~lLYv SC~fVlUL(. <br />3qb~O A(YJL1'tiYST wAy <br />S4Jvl L <br /> <br />~~ <br />Cf ( \( 'd- <br />.J -111' /31~/ <br />qO'1/ <br />PHONE <([3 7ro 4103 <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) 'A Lf BLOCK <br />PARCEL LD.' ~ -l{,,-.t\-OOX) ... 00 roo -- 1..'1 <br /> <br />SUBDIVISION <br /> <br />~M7:~n f>d\AI1<!" <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:-.Jl-New Construction _Addition _Alteration _Repair _Install <br /> _Sign _Kove _Deaolish <br />PROPOSED USE: --KL-s ingle FUlily _KIF _' of Units _K/H <br /> _eo..ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />DESCRIPTION OF WORK: V'l1b..1J'I (:J/\. G-lA-ss IGV1 ~ <br /> <br />BUILDING SIZE: \5 X .35""" . Square Feet. Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />_BUILDING <br /> <br />$--1~3'f1- oQ <br /> <br />PERKITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'fRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_ttECllAMICAL <br /> <br />$ <br /> <br />-0 <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _FrUle _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />Signature <br /> <br /> <br />"CONTRACTOR SECTION <br /> <br />COMPANY 9/NU C~AJS7 <br /> <br />State Cert. or Regist. , <br />City License Registration' ~.2 /., t: <br />* **************************************** <br /> <br />V"" <br /> <br />RUn.DER <br /> <br />COHPARY~' -l~ <br />State Ce . or Regist. # <br />it License Registration # <br />*********************************** <br /> <br />~4-L <br />~ .1/S 'J <br /> <br />V" <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration t <br />****************************************** <br /> <br />IlEGBANICAL 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 />