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<br />APPLICATION FOR PERl-lIT <br />CITY OF ZEPIIYRHILLS <br />BUILDING DEPARTl'1ENT <br /> <br />APPLICANT \. ~/ ~ ~ -dJh <br />ADDRESS cr --'-"9 i- ') .... . - . ~P,-l;V1i;~NE <br />OWNER t ~,~l>~ <br />JOB LOCA- ::j-' -f~' - - '''1, LOT SIZE <br /> <br />~r- ;J~3 2- <br /> <br />x <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. ~~ <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ~Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />____Hove <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />~M/F <br /> <br />_i~ of Uni ts <br /> <br />.._M/H <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />-SWA;l~Ol , :/"~~. <br />APproval~,j;i:j'H ~,}-' <br /> <br />Square Feet, Height <br /> <br />____Restaurant & Health Department <br /> <br />BUILDING SIZE: <br /> <br />x <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 FOmlS. ** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />EERMITS REOUESTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />~MECHANICAL <br /> <br />AMP Service' <br /> <br />Florida power Corp. <br /> <br />_H.R.E.C. <br /> <br />$f~ 'f<;?~ Lj -5- Valuation of Mechanical Installation <br /> <br />____PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />.#'.. . <br /> <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />Signature <br /> <br />~ONTRACTOR 0ECTION <br />Company <br />State Cert. or Regist. 0 <br />City License Registration 0 <br />****************************************** <br /> <br />J3UILDER <br /> <br />Sif:Tnature <br /> <br />Company <br />State Cert. or Rcgist. 0 <br />City License Registration 0 <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Signature <br /> <br /> <br />Company <br />State Cert. or Rcgist. 0 <br />City License Registration # <br />* ************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company 3 V 9-5-~;t:id~~ ~ <br />State Cert. or Regis t./ ,f .A V <br />City License Registration iirF .2. <br />************************************* <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration # <br /> <br />PTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />~~:;::~~;~~***..~..*.*.*..**** <br /> <br />PERNIT OFFICER. <br />