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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME B~~ aJk~ .-' <br />OWNER'S ADDRESS 3 tf" () b.3 /-.fw'; II 0/1 ,L..~ <br />JOB ADDRESS 0/1 /JJ E <br />LEGAL DESCRIPTION: LOT(S) to BLOCK SUBDIVISION ~~W.lfR L) W/ #..[) <br />PARCEL I.D.' / ( - ~ -,+.! - 0/10 - t?OOCJO -4~ <br />WORK PROPOSED:~ew Construction ____Addition Alteration ____Repair ____Install <br /> <br />PHONE f 7 If - / (, ,;z. ?' <br /> <br />____Sign <br /> <br />Move <br /> <br />Demolish <br /> <br />PROPOSED USE: &ingle Family <br /> <br />____M/F ____' of Units <br /> <br />2SM/H <br /> <br />Commercial <br /> <br />Indust. ____Swim. Pool <br /> <br />Other <br /> <br />____Restaurant & Health Department Approval <br />BUILDING SIZE: ~;- x~, RfI};I/ lid <br /> <br />Square Feet, <br /> <br />/~ t:J r <br />, <br /> <br />Height <br /> <br />RESIDENTIAL: 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 CON'l'RACT REQUIRED. <br /> <br />PERMITS REQUESTED <br /> <br />~BUILDING <br />~ ELECTRICAL <br />)( MECHANICAL <br />~PLUHBING <br /> <br />$ 3 J=; (J-irV . 0-0 Valuation of Total Construction <br />/ <br />/~ AMP Service ~ Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION : ____Block ____ Frame Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BUILDER <br /> <br />CON'l'RACTOR SECTION <br /> <br />~ ~ COlPAIIY 81 r h.v <br />?ff97.:{1State Cert. or Regist.' // /'7 <br />~'111'../' ~~ . Ci ty License Registration' 4~-:['7 <br />. ***** *********************************** " <br /> <br />tPotJSL( <br /> <br />Signature <br /> <br />ELECTRICIAN~ COMPAIIY EIl'rm'C('l 'SYSkms &n1. <br />, State Cert. or Regist.' S;;Z 7,3' <br />Signature ~ Ci ty License Registration # h I <br />* ***** ********************************** <br /> <br />PLUMBER <br /> <br />~ COlPAIIY 'G" vi <1.0'" ,,,",,,,, h \ <br />. State Cert. or Regist. . <br />~ ~y License Registration . <br />' ~.............................. <br /> <br />to r\, -h-c. c. tv rs <br />4<1f/b <br />7'6 <br /> <br />Signature <br /> <br />~ ~ COlPAIIY t:,...Villo"'.......n 1".1 C"w\.rc..d""" <br />. State Cert. or Regist.' 3s&JZ- .. <br />~ ~ C. Y License Registration # I-fLf <br />, ~ ~..~...................... <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />OTHER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />