Laserfiche WebLink
<br />OWNER'S.lWtE Er rJ r ff ~ /l1 /:5 <br />OWNER' S ADDRESS :3 8;Z ) :3 7 :a.. /} v ~ <br />5if~~ <br />LEGAL DESCRIPl'ImI: urr(S) /:3 - ( C <br />J J ,.<~ ,.< / <br /> <br />JOB ADDRESS <br /> <br />PARCEL 1. D.' <br /> <br />APPLICA'I'ION FOR PERKIT <br />CIn: OF ZEPllYRHILLS <br />BIJJIlJ)TIliG DEPAR1'lIfENT <br /> <br />. , . . <br /> <br />PHONE '7g~-- ~3,-{ J <br />--rS - -if. <br /> <br />BLOCI{ /%l'_SUBDIVISIOlil <br />00 /0 <br /> <br />:58 71~ ~G 177 <br />CJJ3~ <br /> <br />/...<. :? <br /> <br />ocr <br /> <br />WORK PROPOSED:_!I1ew Construction ~ition K.Alteration _Repair _Install <br />_Sign _Move _Deaolish <br /> <br />PROPOSED USE: X Single Faaily <br /> <br />_KIF <br /> <br />_, of llfnits <br /> <br />_M/H <br /> <br />_ec-ercial <br /> <br />__Indust. <br /> <br />_S.n.. Pool. <br /> <br />Other <br /> <br />_Rest:aurant &: Healt:h Depart:aent Approva1 <br />)~/ ~ <br />BUILDING SIZE: / X /7. X 8')' Square Feet. <br /> <br />4BUILDING <br />4ELRCTRICAL <br />.~CAL <br />tf/t PLUKBING <br />TYPE OF CONSTRUCTION: _Block ~Fraae __.Steel <br />FHiISHED FLOOR ELEVATIONS: 8# w.. IS PRt 'JECT IN FLOOD ZONE AREA? <br /> <br /> <br />COm'RACIOR SECTION <br /> <br />COfPMIV_.. r A, G./f/R-7~ c~~~ <br />:r.:.a~e Cc~". or Regist. " <br /><<.;~: Ly 'i:.:~t:.."lse Registration , ]~~ <br />........................................"'.........i':...'i::'l:* .'. :IlI*..,.....................*........................ <br /> <br />=CIAR~ ~ ampA1:~ rrd ~ <br />/ . . S1:ate C~rt. or Regist. , E:.IICC <br />Si ture." .1 V A ~ . City I.lr..nse Registration t r.jl <br />/ "'......... ..............................................-il:...,i':*.....................*........."'......' <br /> <br />RESIDENTIAL : <br />COttMERCIAL : <br /> <br />BUILDER <br /> <br />Signature <br /> <br />PLDKBER <br /> <br />Signature <br /> <br />KECHARICAL <br /> <br />Signature <br /> <br />0T1IF.R <br /> <br />Signature <br /> <br />~~- ~_ /0" Height <br /> <br />ATTACH (2) PLOI' PI.AICIS &: (2) SEiS OF BUILIlING PLMS 5: (1) SE'f ENERGY FORMS. *'* <br />ATTACI (3) SETS OF BUILDIBG PLUlS &: (1) SET ENERGY FORKS....... <br />"''''COPT OF COn'RAGT REQm:KIlD. <br /> <br />PERKITS REQUESTED <br />~ ~ <br />$ . / j' c:f) O'?:)... < Valuation of Total Construction <br /> <br />~C5 AKP Se:C"?ice Lplorida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Va1uation o~ Kechanical Installation <br /> <br />GAS <br /> <br />V' ROOFING <br />. <br /> <br />#/r <br /> <br />/ <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />~ <br /> <br />YES NO <br /> <br />...............*...............:k i:&-..........................."......*...........................*.................. <br /> <br />4~- <br /> <br /> <br />.::. .~:~." .~: ",-.#1...1' -A.n..F.,_ft...,~. ...,..IIl............a....~.... .JI-.....,...4....a............~,.I'\.......$.....ll!o_,A.~."='+-!' <br /> <br />COlIPMY <br />State Cert. or Regist. , <br />City License Registration I <br /> <br />~ COlIPAJMY <br />State Cert. or Regist. I <br />. C'~ ~- City I.icense Registration I <br />......"'......"'''''4'.........'''...'''.........-:2:...'''...**''',;,'''............'''.........'''..................... <br /> <br />CO!IPdY <br />L1::/ ~ State ~rt. or Regist. " <br />~ ~ City License Registration . <br />, ......*...............~*......*..."'..................*......*.........*....................................... <br /> <br />. <br /> <br />APPLICAnOR APl'IlOVW BY ?1 tl,AI G- ,0 '^-<"-' r <br /> <br />PERKIT OFFICER. <br />