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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />ADDRESS .5 3~ 7 <br /> <br />OWNER <br />JOB LOCATION S?~ 7 J3M <br /> <br />/2 ~ Sf <br /> <br />. <br /> <br />PHONE <br /> <br />76"~- CJCJ6,?' <br /> <br />5/-, <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br /> <br />PARCEL 1. D. # / / ' Q /.;.,- 1 (- 00 ) 0 - I 713 0 () - 0 I <f 6 <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />____Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____# of Units <br /> <br />,____M / H <br /> <br />____Commercial <br /> <br />____Indust. <br /> <br />____Swim. Pool <br /> <br />Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />~ <br /> <br />BUILDING SIZE: <br /> <br />x <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 />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />c5(, ~;20 <br />JSO <br /> <br />AMP Service <br /> <br />Valuation of Total Construction <br /> <br />>\ Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />____ELECTRICAL <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 <br /> <br />____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />::::::::~ Company ~;<.i.A.rJ (l r.., JJ. {j E'~dr;<- <br />. State Cert. or Regist. # <br /> <br />- -. - - ~.......~:;~.;:;;~~;.~;~~~;~:;;~~ i/ 0 n <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City Licebse Registration # <br />****************************************** <br /> <br />Signature <br /> <br /> <br />Company 13/~#.e ~ htJ/JAA/z 0..4-> fJ~'#~ <br />State Cert. or Regist. # CAC,~ Y:J 9 Y.f> / <br />City License Registration # I 7 <br />****************************************** <br /> <br />OTHER <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />