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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER · S NAKE Act? {.(. S -r-c... <br /> <br />& 0" (I MIf",J <br /> <br />PHONE <br /> <br />OWNER' S ADDRESS <br /> <br />JOB ADDRESS SA 3 7 <br /> <br /><' ",'-J <br />....:>c...o ,;-;", ~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVlSION~M1J1 Re.J/ /?1, Jf. f' <br /> <br />PARCEL 1.D.,/0':1.6-2.,/ - 00/0 .... 07J>Of/r~ 000.1 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br /> _Sign _Move _De.wlish <br /> / <br />PROPOSED USE: _Single Faaily _H/F _, of Units VK/H <br /> _ec:-ercial - Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: /2-. X 41 <br /> <br />4 q 2.. 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 />PERMITS REOUESTED <br /> <br />v-BUILDING <br /> <br />$ ~ 0-00- <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />~Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KEGIIAN1CAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />~- <br />YES NO <br /> <br />..........******.***.********.************ <br /> <br />CONTRACTOR SECTION <br /> <br />BllWIllll COIlPAllY O~ In, 1f.5 <br />~ State Cert. or Regist. f <br />Signature .(.J...l ~ J) City License Registration f '77 <br />*****.***********************.************ <br /> <br />COMPANY ('Jf H- 0 (V-J) oJ ~~ E / ~ $-- <br />State Cert. or Regist. t '\., <br />ity License Registration t ~ ~ <br />**********.*************.************* <br /> <br />COMPANY Qq; 11 d~{ H,,,- E h-~ <br />State Cert. or Regist. , <br />City License Registration , <br />************************************* <br /> <br /> <br />PLUMBER <br /> <br />Signatur <br /> <br />37 <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration f <br />.*.***.*.***************.**..************* <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />COHPANY <br />State Cert. or Regist. t <br />City License Registration , <br />******.*******************.*..************ <br /> <br />OTRRR <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY 'JIt,AM' A~ ~ j7~ <br /> <br />PERKIT OFFICER. <br />