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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE <br /> <br />wI! 'r~ 1::" Y/..y/iIC,-"'-. <br />r~ t;.Lo ->b~ <br />S4MG-- <br /> <br />PHONE ,J'/ ] - ?.)I,2.;-( ~.l.J' <br /> <br />OWNER · S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: I.OT(S) BLOCK SUBDIVISION <br />PARCEL I.D.' //--2(,. 2/ -cJ (JIG c-/~f}-O '-o.4UIfOBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ~ _Install <br />_Alteration _Repair <br /> _Sign _Move _Deaolish <br />PROPOSED USE: _Single Faaily _M/F _' of Units _M/H <br /> --~ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health DepartBent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />.. <br />R t'/YltJJ1trL I~ <br />!'qp-( <br />X er u. y (}o:; I Square Feet. Q...1:) <br /> <br />Height <br /> <br />BUILDING SIZE: "1 J <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 CONS:mUCTION. <br /> <br />PERKITS REQUESTED <br /> <br />./BUILDING <br /> <br />$ <br /> <br />:2 , 900 <br /> <br />/ <br /> <br />~ <br />--- <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AHP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUHBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUC'l'ION: _Block _Fraae _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 />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration f <br />****************************************** <br /> <br />Sianature <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />OTHRR COMPANY C t If)" If. A L FIw~"1 (/It!? A (;At'eS71 ~ ) ":;?A.le., <br />. ~"A.# ~ ~ ~ ~ .i .d' State Cert. or Regist. f - <br />Signature W~ ~- .....ec.-. City License Registration .7tJS <br />*~************************************ <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />