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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE <br /> <br />ch Qv /.t2A <br />3.& 7 ~o <br />~a I/n (? <br /> <br />~~~y )t',Jj__ <br />~ ,4./ ~ <br /> <br />PHONE "/ 8~ ... ;;2.. dJ... C; .5 <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BWCK SUBDIVISION <br />I 08;0 <br />PARCEL I. D.' /. .- ;2. tP - ~ J - 0 0/ c> - ,;z 0 J o-t:> - (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install <br /> <br />____Sign <br /> <br />____Move <br /> <br />_Demolish <br /> <br />PROPOSED USE: ____Single FaBtily <br /> <br />____M/F <br /> <br />____, of Units ____M/H <br /> <br />____C~ercial <br /> <br />_Indust. <br /> <br />____Swim. Pool ___Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />____Restaurant & Health Department Approval <br />"3 -4 Y#>tJ <br /> <br />/}/c <br />/ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PWT 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 />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />L.m:CHAlUCAL <br /> <br />$ <br /> <br />AMP Service <br />cZ. S- C'"tJ,... CJO <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />Valuation of Mechanical Installation <br /> <br />____PLtJHBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block _FraBle ____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 />BUILDER <br /> <br />ELECTRIClAB <br /> <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration' <br />****************************************** <br /> <br />! / / 7 COMPANY /VJo f-1DJ <br /> <br />~~ State Cert. or Regist. # <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />ure <br /> <br />e It~~ltl<e <br />~1 <br /> <br />PLUMBER <br /> <br />t~ <br /> <br />COMPANY ,r{,' <l\J~~ C .s:>?V ~ <br />State Cert'. or Reg . ## C/O c ;;J., <br />City License Registration , 7 I <br />****************************************** ~ , <br /> <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />OTRF.R <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 />