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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />1-/0 <br /> <br />-z; 0 <br />. <br /> <br />OWNER'S NAKE <br /> <br />;::-/ 0 r ,x 01. q VVl Qd ; ca { C-! /I ,. C- PHONE <br />OWNER'S ADDRESS C 'J ~ 10 q (h 0- {' k. ef- ~(A 0<. r ~ ~ Z .eft, '1rh ,'/ / S <br />JOB ADDRESS /1 E' J 0 9 VVl 0. rite f- <- <:::;?J U a r ~ / Z Q ph '/ r J, ; I J .5 <br />BLOCK SUBDIVISION <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ---Alteration _Repair _Install <br />0ign ---,,"ove _Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br />/"" ec:-ercial <br /> <br />_M/F <br /> <br />_' of Units _M/H <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: W Q , 1 <br />BUILDING SIZE: :!:i.')' X /5)-'. <br /> <br />6 ~8 Y\ . <br /> <br />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 />L.BUILDING <br /> <br />$ !:J/LRO.O () <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />_MECIWIlCAL <br /> <br />. <br />AtIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Kecbanical Installation <br /> <br />_PLUKBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDlISBED FLOOR ELEVATIONS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br /> <br />t ~ .-pAllY ~ ~pr/; ~'ifn ffl':f <br />/W ~ State Cert. or gist.' E - O~ .. 3;;' <br />~d. City License Registration . ~ "70 <br />.......................................... ~~~ <br /> <br />RIITl.DER <br /> <br />Signature <br /> <br />~(~ Y1-,,~e <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />......................*...............*... <br /> <br />RT.RCTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />..**.....*..*..*........*...*........*.*.. <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />...........~................*.*...*..**.*. <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />....**...........**........*....*.....***. <br /> <br />OTRg '\ <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />