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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME 1J'1/l./V ~-- <br />OWNER'S ADDRESS <br /> <br />PHONE <br /> <br />JOB ADDRESS L. G / S /tI8 <br /> <br />S"' ;J 10 I Sc 0 -r; "'" <br /> <br />LEGAL DESCRIPrION: LOT(S) <br />PARCEL LD.' 10 2." -...1 <br /> <br />BLOCK <br />1_99 Lcf"iS' <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />~ve <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />_M/F <br /> <br />./ <br />_' of Units (./'" MIH <br /> <br />_<=<-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPrION OF WORK: Mt7b ,~/ " H"-'hf- <br /> <br />BUILDING SIZE: / Y X S-Q, 70-<' Square Feet, <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 />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />3~~ <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 />_MECllAlUCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />~LUKBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />Yr. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BlJTI.DER <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY p~ <br />~ State Cer<. or Uegist. . <br />Wo.r--P... City License Registration' <br />** *************************************** <br /> <br />Signature <br /> <br />~~ <br /> <br />Signature <br /> <br /> <br />COMPANY :3~ ~ <br />~ State Cert. or Regist. . <br />.t7~ City License Registration t <br />~**************************************** <br /> <br />COIlPAIIY .- ,e7~ <br />~ State Cert. or R ist.' <br />~ City License Registration f yy <br />**************************************** <br /> <br />COMPANY ~ 1./ ~ ~ A ojO.4;v 2 ...t.- ~ <br />te Cert. or Regist. f CAL:O Y3Y Y $ <br />City License Registration' /7 <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />SianAture t..AJ' ~ <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />L-J~ <br /> <br />MECHANICAL <br /> <br />OTHER <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />