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<br />APPLICANT <br /> <br />~)NO~ <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYIDfILLS <br />BUILDING DEPARTMENT <br /> <br /> <br />0'> Q f:-'S,~ C ~..:::, <br /> <br />~~~~ ~~~~,.y- L~ <br />l \ t-...") H-3\~(\...:"\ <br /> <br />~ 6 D \...1..>-. vY)'""') <br />PHONE .., 'dL lo~ \J_ <br />'M \..\( ) <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />JOB LOCATION <br /> <br />60 f(>r.€-; 194>6 W \D(,UI ",(J LOT SIZE <br /> <br />x <br /> <br />AREA SQ.FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. j~ <br /> <br />JL! -db- J-I- tJ <br /> <br />~- 0 <br /> <br />WORK <br /> <br />PROPOSED:____New Construction ~Addition ~lteration' <br />'BJ. \ \....-~ \rSO-oO b~ <br />_Sign/Temp. ____Sign <br /> <br />~epair <br /> <br />____Install <br /> <br />_Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />_M/F <br /> <br />____4~ of Uni ts <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 />BUILDING SIZE: <br /> <br />L-. <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 />v--/ <br />____BUILDING <br /> <br />$ c-.l. If ;J.. 7, tID <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 />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING SPECIALTY <br />,1 <br />TYPE OF CONSTRUCTION: _Block _Frame ____Steel ~~~~er <br /> <br />FIN ISHED FLOOR ELEVATIONS: __FT. <br /> <br />****************************************** <br /> <br /> <br /> <br />CONTRACTOR SECTION <br />Company 1_. ~ ff\ C _ '( L\J... <br />State Cert. or Regist. # <br />City License Registration # -4-7 <br />****************************************** <br /> <br />C~~\ <br />" <br /> <br />/~.".-/~:::--- <br />Signatur-e"L / <br />..- r - <br /> <br /> <br />Company ---fY)~ bl ~,1p. "\ <br />.- "yYJ -;-- State Cert. or Regist. 4~ G:.. 1'9 <br />{I /11,,"7/f())'I.- 17 City License Registration 4~ - <br />***********~***************************** <br /> <br />ELECTRICIAN <br />Si"n.~ure ja?Y'.!'( <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # - <br />****************************************** <br /> <br />PLUMHER <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. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />*******************2********************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />