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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAME <br /> <br />59 iMfJ tI1 S, COfA-'fRf.ctJ()kl-VS/!PI1/1t/'_t/S PHONE 1 ~~ t - 6 6~ 6' <br /> <br />OWNER · S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />$$0'1 <br /> <br />ST_~ ~ + <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. t <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_H/F <br /> <br />_, of Units _H/H <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool ___Other <br /> <br />_Restaurant & Health DeparbBent Approval <br />DESCRIPTION OF WORK: (:jJ;/J-<. W#f",(. io v/l S -M':~5 /~.d.--e kf'cvf <br />, /, <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 /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br />~UKB~NG <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPEC~TY <br /> <br />TYPE OF CONSTRUCTION: _Block _~e _Steel <br /> <br />Other <br /> <br />FlRISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAR <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />SianAture <br /> <br />PLUMBER <br /> <br />t4;,// COIlPANY /;,m&t P 1v_.6/.-""1 <br />/ --- State Cert. or Regist. t <-' <br />. -;;:JMT"A City License Registration t <br />.. ****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert" or Regist. f <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />OTHER <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />