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<br />APPLICA'l'IOl!il FOR PERKIT <br />CITY OF ZEPllYRHILLS <br />BUJIll)I5G DEPARnIE'.NT <br /> <br />Go L D Kft. '('~ tIJ / HIJ M &.- <br />OWNER'S ADDRESS .f'lJ~/) SmrE -{(n. S'y <br />JOB ADDRIiS~.t=3 J>J>~S'41. MWA"vO/) Ll:JotIJ <br /> <br />OWNER'S NAME <br /> <br />S/lLtf S PHONE 1 RO. 7.f9o <br />ZjfP)JyjeJlIJ.,L~ ~~. J:l ~r,I/ <br />/AlIJ-YIAI/J,eLJ IV/,up:s ~/;f-.I11A' k <br /> <br />LEGAL DESCRIPTION: LOI'(S) <br /> <br />BLOCK <br /> <br />SUBDIVISIOI!i <br /> <br />PARCEL LD.I <br /> <br />/'1- :26-J /~ CJ/6o- t)CJc70~ - t'/tPt?O <br /> <br />WORK PROPOSED: ""--lSlew Construction ~ition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: ;..../' Single Faaily <br /> <br />_H/F <br /> <br />_' ot: t'Units <br /> <br />_K/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swill. Pool <br /> <br />Other <br /> <br />~estaurant &: Healt:h Depart:aent Approval <br /> <br />BUILDING SIZE: J / X ~ <br />. <br /> <br />hSO HN.oe~ ttotJp;. Square Feet. <br /> <br />p , 7"'t'J 9' ' <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COHHERCIAL : <br /> <br />ATTACH (2) PLOI' :PI.A.NS &: (2) SETS OF BUILDII!iG PLiUilS &:' (1) SlIT ENERGY FORKS. U <br />ATTACH (3) SETS OF BUIIJ)ING :PI.A.NS &: (1) SET IOOJRGY FURHS.** <br />**COPY OF COI!iTRAC'I" REQrnrRED. <br /> <br />PERl!lITS RROOE."iTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />~9qb.t90 <br /> <br />Valuation ot: Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />s <br /> <br />Valuation ot: Mechanical Installation <br /> <br />_PLlJKBING <br /> <br />GAS <br /> <br />ROOFDiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTIOI!i: _Block ~Fr3lle _Steel <br /> <br />/9Lt/ /I? . <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVA'l'IOl!ilS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZOI!iE ARE..\? <br /> <br />YES NO <br /> <br />***************.**.***.******************. <br /> <br />COfl'RAC'IOR SECTION <br /> <br />BUILDER <br /> <br />CO!tPANY /I c.E /7 LU I?"J <br />/J J? / -? /J _ State Cert. or Regist. 4# ~CO r3 YbPO <br />~~ City License Registration 4# ./.t.b <br />**************...************************* <br /> <br />Signature <br /> <br />ELECTRICIAH <br /> <br />CUlIPANY <br />State Cert. or Regist. ~ <br />City License Registration 4# <br />*.**********.*...****..******************* <br /> <br />Sismature <br /> <br />Signature <br /> <br />CO!IPANY <br />State Cert:. or Regist:. 4# <br />City License Registration , <br />******.*..**********.********************* <br /> <br />PLDtBER <br /> <br />Signature <br /> <br />CO!IPMY <br />State Cert. or Regist. , <br />City License Registration , <br />.*...*.********.************************** <br /> <br />KECHAlUCAL <br /> <br />CO!IPMY <br />State Cert:. or Regist. 4# <br />City License Registration I <br />**.*****.*.....*..*..********************* <br /> <br />OTHER <br /> <br />Signature <br /> <br />APPLIF~;;~;;r/1d4u'A <br /> <br /> <br /> <br />L_'""__"H_'''''"'''''_'''~'' .,', _', _ d <br /> <br />>4cflA J'L..I~ <br /> <br />J.., <br /> <br />, " ,"'-"'7 P~'"".'.'. <br />'i.B"'<' <br />. ""J; <br />" ".... . <br />i - .' -...~..... <br />.',-,.._~,. <br /> <br />OFFICER. <br />