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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAKE <br /> <br />(Mr/htzt <br />,r9os- <br />,~()S <br /> <br />(;'11 !l.J?& t r- <br />~~O;t) g;;,~R rT <br />6$~~uft.A ,'A R (/ 7 ~Y.)/R /;"(1.5.. F~ S5S.Y'/ <br />SUBDIVISION lAAOJ5, (0 U/ho j) It( If M.It.. <br /> <br />PHONE <br /> <br />;7i?D - d-.?7,6 <br /> <br />OWNER I S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL 1. D.' !f) ~ ~ In . ~ 1- IJ I;).. () - tJO C)(?)("l- ('J s;-~ ~(J (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction _Addition -U-Alteration ~epair _Install <br /> <br />_Sign <br /> <br />--1tove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single FSIIily <br /> <br />_M/F <br /> <br />_' of Units _M/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Depart.ent Approval <br />DESCRIPTION OF WORK: Allf^-- E;{:r;.1flt 'r h tv, ~ P ("JlV'e 5 4/1',o/L t' <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDERTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET END.GY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />_BUILDING <br />lX-KLECTRICAL <br /> <br />$ C*JQ. <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-1IECIIAlIICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fralle _Steel <br /> <br />Other <br /> <br />FlBISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUTI.DRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />:::~CI"" f'~ COMPANY!/A~ E-AO- pf51l Rn//lrM1Y <br />~ State Cert. or Regist. , ~ <br />ef7 - City License Registration' ?,~t.. <br />****************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />OTRRR <br /> <br />" <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />