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<br />^PPLICATION.-..~ PERI'I1T <br />CITY OF ZEPHYRlITLLS <br />BUILDING DEPARTMENT <br /> <br />)WNER <br /> <br />'-(81- "L <br />/\(O-A.- VVI. <br /> <br />P/~ ~ <br />G o.JJ ~. I 2~7Pb. /;::~ ]1 s-'f) PHONE 78 i. - 7.i' J'-r <br />;(~ . 7'cJrfl 1-I/<r:>H4JtJD (j1J-/[ ( IJ~ #1;,./6 -[/JIVI;O/f :J.l' l/7 <br />" <br />39J3<" U~ RJ ' <br /> <br />Cc- <br /> <br />,PPLICANT <br /> <br />.DDRESS <br /> <br />g/:y&J7.l-7~ <br /> <br />JOB LOCATION <br /> <br />LOT SIZE <br /> <br />x <br /> <br />AREA SQ.FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL I.D.t~ ;)(, - fJ...'1 <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />~iY~ <br /> <br />WORK PROPOSED:____New Construction ____Addition <br /> <br />____Alteration <br /> <br />_Repair <br /> <br />'/Install <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />_~Iove <br /> <br />____Demolish <br /> <br />____commercial <br /> <br />_Indust. <br /> <br />_Swim. Pool <br /> <br />,._M/H <br />~:.... S-+~Other <br /> <br />PROPOSED USE: ____Single Family <br /> <br />_M/F <br /> <br />_t~ of lIni ts <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 FORt-1S.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />rF.RMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_H.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />.:1' <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 />Signature <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Rcgist. n <br />City License Registration n <br />****************************************** <br /> <br />]3UlT.DER <br /> <br />Si!mature <br /> <br />Company <br />State Cert. or Regist. n <br />City License ReGistration n <br />****************************************** <br /> <br />ET.F.CTRTCTAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. n <br />City Lic~nse ReGistration 0 <br />**********************************~~~***~~ <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Rcgist. 0 <br />City License Registration ff <br />****************************************** <br /> <br />MECHANICAL <br /> <br />OTHER M lU~~'- T, 0",J{" Company P0-/3L-l-< G~<' Ce, <br />~ State Cert. or Regist. il :;;JG,,;l-8 <br />Signature tlV'\ _ City License Registration i~ ? :2_~ <br /> <br />~............~................*...... <br />APPLICATION APPROVED BY ... ,H-<' G _.l;L 0 A Ai>, T;- PERMIT OPFICER, <br /> <br />/' <br />V <br />