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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S ADDRESS <br /> <br />( 1--1 t< l-c rt C~ F <br />.c7A fYl. E <br /> <br />c)-{ /11 . Gj r <br /> <br />PHONE <br /> <br />7~7- ;() L;o <br /> <br />OWNER'S NAKE <br /> <br />JOB ADDRESS "ll 7 ~'l <br /> <br />A.v c <br /> <br />Z p,of/~? It!. L S <br /> <br />fiA )).)~O <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1.0.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction ~ddition ~lteration _Repair ~nstall <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Family <br />..&ec-ercial <br /> <br />~/F <br /> <br />_, of Units _M/H <br /> <br />_Indust. <br /> <br />_Swia. Pool ___Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />A~() <br /> <br />& Health Department Approval <br />) 5".0 (T t]V-fTF/vl <br />I <br /> <br />_Restaurant <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 FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKlTS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />~GHAIIICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />s=::2ooa ,60 <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: _Block _FrUle _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 />CONTRACTOR SECTION <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />************************************* <br /> <br />RUTI.DER <br /> <br />Signature <br /> <br /> <br />OMPANY <br />tate Cert. or Regist. , <br />ty License Registration . <br />***************************** <br /> <br />/~ <br /> <br />PLUHB~ <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />*************************************.***. <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. * <br />City License Registration . <br />***.**..****.*......*............*.*.*.*.. <br /> <br /> <br />~ <br />~ <br /> <br />COMPANY Ebv.../f"V\4/\/ /1 r= c 1+4-#1 -'-I( L 7-E;tu, 'CF FIL-C. <br />State Cert. or Regist. , C A G c) (/;). (".0 I Y <br />~ity License Registration , <br />*******.**...*****.**.*******..**.*..*.*.. <br /> <br /> <br />OTRRR <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKlT OFFICER. <br />