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<br />APPLICA'I'IOl!ll FOR PERKIT <br />CITY OF ZEPHYlUIILLS <br />BlllIJ)DIG DRPAlt'IKUI' <br /> <br />OWER'S lWfE ~ r-\~ho~ '-/ rrW~R -t-9-l ( <br />OWER'S ADDRESS ~ <1 '71 (;,., <br />JOB ADDRESS 3CJllCo Mf:A1>Ol-.1 <br /> <br />PHONE <br /> <br />rnFflcl aU) WOO1"J Ko ap <br />~)P )....~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BJh.';.'K <br /> <br />SlBBDIVISIOfil <br /> <br />PARCEL I. D.' <br /> <br />/:3- :J&- 2/-/f(- D- ~ <br /> <br />KORK PROPOSED:_lIfev Construction --i\ddition _Alteration ..2C-Repair _Install <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_Deao1ish <br /> <br />PROPOSED USE: j<'- Sing1e Falli1y <br /> <br />_KIF <br /> <br />_' of llfnits <br /> <br />_K/H <br /> <br />_~rcia1 <br /> <br />_Indust. <br /> <br />_Swill. Poo1 ' <br /> <br />Other <br /> <br />l.(,r) ~ L <br />BUILDING SIZE: L. X _...J . .:>, <br /> <br />_Restaurant &: Hea11:h Deparblent Approva1 <br />,.S: <br />/'70D ..+J. <br /> <br />Square Feet, <br /> <br />Height <br /> <br />. , RESIDENTIAL: <br />COttKERCIAL : <br /> <br />A'l'TACII (2) PL01' PUUIIS &: (2) SEI'S OF BUllDDiG PLUS &: (1) SET ENERGY FORKS. ** <br />ATTACH (3) SEI'S OF BUII.DIlIG PLUS &: (1) SET ENERGY FORKS. ** <br />**copy OF CORTRACl' JUtQUIRIlD. <br /> <br />PElDlITS REOUESTED <br /> <br />_BUILDING <br /> <br />Z/ <br />$ ~{">~C' C5> <br /> <br />Va1uation of Tot:a1 Construction <br /> <br />~ELECTRICAL <br />~flECllAlUCAL <br />~PLUKBIHG <br />TYPE OF COHSTRUCTIOllf: Y B1ock. _~ _Stee1 <br /> <br />MIP Service F10rida Power Corp. <br /> <br />W.R.E.C. <br /> <br />s <br /> <br />10/0 Va1uation of Hecbanica1 Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FInSHED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COJIIIlTRACIOR SECT'IOIN <br /> <br />BIJTTJ)ER CO!tPM'Y ~'"? EG, H5J.:.J~ Y I q..) C_ <br />tV\. M State Cert:. or Regist.' C ~ CO~~ ~<;.c, <br />Signature ~~ City License Registration , <br />\ ~ *************************************** <br /> <br />ELECTRICIAH <br /> <br />SiPllature <br /> <br />~/f1 <br /> <br />CO!tPAJNY <br />State Cert:. or Regist:. , <br />City License Registration I <br />'****************************************** <br /> <br />PI.OttBER <br /> <br />CO!tPARY <br />~ . State Cert. or Regist. , <br />~ } A City License Registration I <br />~************".*************************"'** <br /> <br />Signature <br /> <br />KECllABICAL <br /> <br />Signature <br /> <br />(/'0/ r <br /> <br />, <br /> <br />aJIIPANY <br />State Cert:. or Regist:. , <br />City License Registration , <br />****************************************** <br /> <br />OTHF.R <br /> <br />Signature <br /> <br />N/f1 <br /> <br />aJIIP.DY <br />State Cert:. or Reg1.st. If <br />City License Registration . <br />*************~********~*************"'***** <br /> <br />APPLICATIOH APPROVED BY <br /> <br />PERKIT OFFICER. <br /> <br />. <br />.... ~ ,{ :".', <br />