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<br />APPLICATION FOR PERl'l'IT <br />CITY OF ZEPIIYRHILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER //<- /' / e-, <br /> <br />!lev'! fe) / <br />/Hc, 1 ~~ '1 <br />JOB LOCATION S-- ') I Y ,f( &~ 5 5 I <br />LEGAL DESCRIPTION: LOT(S) Lt>-; <br /> <br />!-/;., 7' et <br />( <br /> <br />T 0-J -e ~5 <br />S <br /> <br />, (fl I Y1 rJ? 'r' l~ C ('Cc ( <br /> <br />'S (,/ ......../c-e <br /> <br />APPLICANT <br /> <br /><. :i',,-' <br /> <br />PHONE ( 7'tJ '1 j 5; / ...s 0 r<? <br /> <br />ADDRESS <br /> <br />J'f'J-O <br /> <br />" <br /> <br />LOT SIZE <br /> <br />x <br /> <br />AREA SQ. FT. <br /> <br />,rl <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. ~~ i). J- (, - ~I <br /> <br />() :J- f'O .. 0 () () 0 0- 0 5 r ( 0 <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ~Repair ____Install <br /> <br />____Sign/Temp. ____Sign _Hove _Demolish <br />PROPOSED USE: ~ngle Family ~M/F _~~ of Units ,._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 />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 FORNS. ** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />J'ERMITS REOUESTED <br /> <br />_BUILDING <br />~ELECTRICAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />/ 7'2' <br /> <br />AMP Service ~/Florida Power Corp. <br /> <br />_\-l.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />.; . <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 0ECTION <br />nUILDER Company <br />State Cert. or Rcgist. " <br />Signature City License Registration 0 <br />****************************************** <br /> <br />F.l,F.CTRTC1bN d~:/<l:-7~' Company C~~A.-<'~~/'~ <br /> <br />~rfl/7//'_r //, State Cert. or Regist. ii no/5-/ 'II <br />Sianature /~ ~/t " ::::x:- L-- City License Registration iF <br />,/ ****************************************** <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration 0 <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />Stat~ Cert. or Regist, 0 <br />City License Registration 0 <br />****************************************** <br /> <br />MECHANICAL <br /> <br />OTHER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration n <br /> <br />APPLICATION APPROVED BY <br /> <br />~, ******************************* <br /> <br />. tit. 'b~ <br />'.l&J ' <br /> <br />PERtHT OFFICER. <br />