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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />'i' <br /> <br />h <br />1'iJ38 -9 j/ <br />r{~3( <br /> <br />OWNER'S NAliE fv14S-K 5,-,c <br /> <br />OA-k. 5 <br /> <br />PHONE <br /> <br />OWNER'S ADDRESS <br />JOB ADDRESS-5 <f-y L( L~ \Jflf L- <br /> <br />\/ -4u If'y 8L-f/O <br /> <br />!-Dr ~l <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. , .:l Z~ - ~ - 0 Q.3lJ - otJ~l'JO - /;// (OBT~IN <br />WORK PROPOSED:____New Construction ____Addition ----Alteration <br /> <br />FROH PROPERTY TAX NOTICE) <br /> <br />____Repair ____Install <br /> <br />____Sign <br /> <br />~ove <br /> <br />____DeJDolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____H/F <br /> <br />____, of Units <br /> <br />____H/H <br /> <br />~r <br /> <br />____COlIlIIIercial <br /> <br />____Indus t . <br /> <br />____Swim. Pool <br /> <br />____Restaurant & Health Department Approval <br /> <br />DESCRIPTION OF WORK: ('lJflP[)fLr, <br /> <br />u - (L-(9e;.-\ {)Y2..1 V l.! w.4 '" <br />/ <br /> <br />BUILDING SIZE: <br /> <br />A--. <br /> <br />Square Feet, <br /> <br />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 />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />5-300. .00 <br /> <br />Valuation of Total Construction <br /> <br />____ELECfRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_hl.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block. _Fraae ____Steel fJ.vVn1 (Alt/fV\ Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />Signature <br /> <br /> <br />CONTRACTOR SECTION <br /> <br />COHPAN'lJJr.J-f (!fftlJfir/l:.UCr,o,v ~ Cf~ p.., <br />State Cert. or Regist. 1i U$C.O S 7 "L <br />City License Registration # ~ <br />****************************************** <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. ~ <br />City License Registration # <br />****************************************** <br /> <br />SiRnature <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. Q <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />I1.E GH.AN I CAL <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration ~ <br />****.**...*****.**.*******************.... <br /> <br />Signa ture <br /> <br />QTIW.? <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />.....*....**.*...************************* <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PE.RMIT OFFICER. <br /> <br />., <br />