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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />(). ~-uO~1h.. <br />U}/if ~ <br /> <br />OWNER · S NAMB <br /> <br />Or-A"" I;>~ <br />, <br /> <br />!llo .sS", ~ ,fANe ~ C>c_do .4.F J. <br />I <br /> <br />J kei <br />Jjvd 1- :1 <br /> <br />PHONE ~/J -. 7l~- 0007 <br /> <br />OWNER'Y"S-ADDKE5S'- $I~ 15- <br /> <br /> <br /> <br />SUBDIVISION <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:____New Construction ____Addition ----Alteration ~Repair ____Install <br /> <br />____Sign <br /> <br />____Hove <br /> <br />____Demolish , , <br /> <br />PROPOSED USE: ____Single Family <br /> <br />-K-H/F <br /> <br />.!L.-, of Units ____H/H <br /> <br />____C~ercial <br /> <br />____lndust. <br /> <br />____Swim. Pool ___Other <br /> <br />____Restaurant & Health Department Approval <br />DESCRIPTION OF WORK: Po .;.. rw- / /~ <' c.. 5 4" 'r /It" AJ DO ,c <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />. ..\YCJ,() Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL <br /> <br />ATTACH (2) PLOT PLAN~ & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF B~LDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQ~RBD FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br /> <br />(, " <br />$ {g;( ~J .- <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 />----1'IECBANlCAL <br /> <br />$ <br /> <br />Valuatioll of Hechanical Installation <br /> <br />____PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUGTION: ____Block ____FrUle ____S teel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJEGT IN FLOOD ZONE AREA? -L <br />YES NO <br /> <br />.........~................................ <br /> <br />CONTRACTOR SECTION <br /> <br />BillJ.DER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.........*................................ <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.........*................................ <br /> <br />SiROature <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />~ City License Registration , <br />.......... ............................... <br /> <br />Signature <br /> <br />HECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />..........~........................... <br /> <br />.7 COMPANY )/W'(; (/; ~t'~7 4. <br />State Cert. or Regist. , CC-co S'19 S-'- <br />City License Registration' 8,.10 <br />.......... ............................... ~ <br /> <br />PERMIT OFFICER. <br /> <br />Signature <br /> <br />OTHER <br /> <br /> <br />Signature <br /> <br />APPLICA <br />