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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />DC) <br />1~.F 4f &fJ'~ <br />vaL r ?1,c,1 <br />f~ 0- c)/.5j <br /> <br />PHONE <br /> <br />OWNER'S NAME :::;;;~P1M~""- ;/t-L e~/L 1-{.r-j <br />OWNER'S ADDRESS ~)o 7 R""S77C O/f;cs 1)12/ i/f7 <br />JOB ADDRESS ~ P11;?1-t',.. -;.I L- L Dr <br /> <br />L-(..( '12 ,. h .33 )~)' <br /> <br />SUBDIVISION -::;;- k..x-tM~'" ~-LL <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 1.D.' <br />WORK PROPOSED: ~ New Construction ____Addition _Alteration ____Repair ____Install <br /> <br />~} <br /> <br />BLOCK <br /> <br /> ____Sign Move Demolish <br />PROPOSED USE: )( Single Family ____M/F ---- , of Units ____M/H <br /> Commercial Indust. -A,swim. Pool Other <br /> ---- <br /> <br />____Restaurant & Health Department Approval <br />BUILDING SIZE: #6' X )b: ~ tJ70 Square Feet, <br /> <br />/ :J ?7J/L 7 <br /> <br />Height <br /> <br />RESIDERTIIC ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ** <br />COMMERCIAL.:<' ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. ** <br />· ~ **COpy OF CONTRACT REQUIRED. <br />\ <br />~ · PERMITS REQUESTED <br /> <br />~UILDING <br /> <br />j <br /> <br />91 t7t'Jc) <br /> <br />, <br /> <br />v(oo AMP Service <br />c1-7a; <br /> <br />Valuation of Total Construction <br /> <br />"'~ $ <br /> <br />BUILDER <br /> <br />"':-- <br />~L~TRIOIL '..;, <br />/" MEC~ICAL .t. <br />----, . " <br /> <br />""""'---PLUMB:twG .. GAS <br /> <br />",'" .. <br /> <br />TYPE OF CON$'.aUCTI~N'::~.-- Block <br />61 '.' ,. <br />FINISHED FLCX$ ELEvATlOlts: / () Il., F'l'. <br />. -:. r~ <br />.. fl.;"; , <br />~#~ . " ****************************************** <br />.",...... ;" ~ '. ~ . <br />.' ., <br />f~~ ~~' .... CONTRACTOR SECTION <br /> <br />\-:""....., :., ,,/ COMPANY -rLAcv ;T 4rlS 7d. <br />' Jl. . ~ State Cert. Qf Regist. I CGCOlb9/7 <br />i/4~~ ':tev:': Ci ty License Registration, /.j' /J / <br />r~' ,**** ************************************ <br />f. .. " <br />.. <br />"i: . ,~ <br /> <br />~Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />Valuation of Mechanical Installation <br /> <br />---ROOFING <br /> <br />SPECIALTY <br /> <br />Frame <br /> <br />Steel <br /> <br />Other <br /> <br />YES <br /> <br />>( <br />NO <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br /> <br />COMPANY~gr\12.t> {; L~c.ir\\_ ~ ~\e ~Cf-.J () <br />State Cert. or gist.' G1CA'~ 3'.,r <br />City License Registration I <br />****************************************** <br /> <br />PLUMBER (2" COMP~/~ Y ~-- <br />_ !/ II _ State Cert. or Regist. 'pFooa", C. // <br />Signature J~Jt~,. ~ City License Registration' /5<) <br />****************************************** <br /> <br />MECHANICAL ~ COMPANY S\.\-e 9 ~AO 0 El"'c:.-\t\L 1. A\ R.. (!.l::lIJl) <br />~ (\ State Cert. or egist. # ~ ~o 7~ol ~ <br />Signature ;p..,,~ \\[l.A.J City License Registration # / <br />****************************************** <br /> <br />OTHER COMPANY I~('~(" \ RDO..L''''j C:D'\'h-.l~\()r I,,",~ <br />Q " (J State Cert. or Regiat. . ~o~ '1s'l"1 ' <br />Signature \ ~-- "'. ,. ~~ Ci ty License Registration . ,) ( . co:l. 9591 <br />****;;;;;r,;******************************* <br /> <br />APPLICATIQR APPROVED BY 'i1tUt.JI~ ::x!f jA~ PERIII'I' OFFICER. <br />