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<br />APPLICATION FOR PEmtIT <br />CI'IY OF ZEPBYRHILLS <br />BUII.DIBG DEPAR'DtllXT <br /> <br />fY\ ~ DA{)~~S <br />\--\ ~ \ b 1) It <br />(J ~ Ave:: r <br /> <br />PHONE <br /> <br />7 8' ~- ff .:3 -7 &, <br /> <br />OWNER · S RAKE ~ D t.. ./\I <br />OWNER'S ADDRESS S II \ <br />JOB ADDRESS 3 8 5 y. g <br /> <br />29-( h '7 f-C..; i \ s <br /> <br />~(, <br /> <br />LEGAL DESquPTImI: LDI'(S) <br />PARCEL LD.'''\- , 1- L t? 2- ( <br /> <br />BI.OCK <br /> <br />SUBDIVISION <br /> <br />DOlO -0'3700- <br /> <br />0' ~Q. <br />I <br /> <br />WORK PROPOSED:_llev Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_KIF <br /> <br />_' of Ilfnits <br /> <br />_K/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_S~. Pool <br /> <br />Other <br /> <br />_Rest:aurant &: Hea1t:h Depar~t Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COHttERCIAL : <br /> <br />AtTACH (2) PLOI' PLAlIS &: (2) SEI'S OF BUILDING PLUS &: (1) SEI' ENERGY FORMS. '** <br />AtTACH (3) SETS OF BUllDDlG PI.MS &: (1) SET mmRGY FORKS.** <br />**ropy OF roWJ'BACT RIlQm:RED. <br /> <br />_BUILDING <br /> <br />$ <br /> <br />PERI!IITS REQUESTED <br />EYD <br />~ 77'S' - Valuation of Tot:a1 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 />Va1uation of IKechanical Installation <br /> <br />_PLUMBING GAS KOOFDIG <br /> <br />SPECIALTY <br /> <br />TYPE OF roNSTRUCTION: _Block _Pralle _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PROJECT lli FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />*****r************~********************** <br /> <br />~"~ <br /> <br />mBTRACI'OR SECTION <br /> <br />BUTT.DER aJIIPANY <br />St:ate Cert. or Regist. ,. <br />Signature City License Registration , <br />.;_>_.--~"---"" *.*"***t~:jl',!il-_it***************************** <br /> <br />,'--- ' '" -~.."- --.., <br /> <br /> <br />---11-- /J LI/l r) ~ //'7 // ~rt:. or R~gist:. _, <br />e ---,If- ~ r fV tf I- - (.7 Co 1::)'>t.1cense Reg1strat1on t <br />***********~~*~********************** <br /> <br /> <br />PLOIBER <br /> <br />aJIIPANY <br />State Cert:. or Regist:. , <br />City License Registration , <br />****************************************** <br /> <br />Signat:ure <br />--.,-----? <br />~ .// <br /> <br />(/'f/ <br />1./ .' <br />Signat:ure ' / . <br /> <br /> <br />aJIIPMY (p ~ S I' t" ( Ikn---1?:v.. <br />State Cert:. or Regist. , ~ I C 0 4;;t "fu '7 <br />City License Registration I -t:t 71 . <br />****************************************** <br /> <br /> <br />0T1IF.R <br /> <br />aJIIPAln <br />StaLe ~:ct:. or Regist. ft <br />City License Registration , <br />************..****.********************.*. <br /> <br />Signatnre <br /> <br />APPLICAnON APPROVED BY <-Jf"".'b <'~ _~~UVV <br /> <br />PERKIT OFFICER. <br />