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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br /> <br />OWNER'S _ C C B;/3:)NT <br /> <br />OWNER'S ADDRESS 3cPorJ:L d/~K' ,{} ~ <br />JOB ADDRESS oJ ~ t' J. '1 b~"1-" r2.~ <br /> <br />PHONE J'/S" fl)J,;2 - / b / J --- <br />,Z - /1';'//5 .L:.L "u <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BWCR <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D.' /*'/ -..J b -:.2/.- (Jae CJ - (, C' 20 (.-~ '~f' ('- C (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~w Construction ~ddition ~lteration ~epair ____Install <br /> <br />_Sign <br /> <br />----"ove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: v'/Single Faaily <br /> <br />____KIF <br /> <br />_, of Units .L'K/H <br /> <br />_ec-ercial <br /> <br />____Indust. <br /> <br />_Swia. Pool _Other <br /> <br />~estaurant & Health Depart.ent Approval <br /> <br />DESCRIPTION OF WORK: 7.10 e.,I. ~ <br />BUILDING SIZE: J../ () X /0 , <br /> <br />ojC <br /> <br />//I/.* <br />, <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATIACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br />~LEGTRICAL <br /> <br />$ <br /> <br />Valuation of Total construction <br /> <br />AHP Service Florida Power Gorp. <br /> <br />W.R.E.C. <br /> <br />----1IEGllAtfICAL <br />~UM8~NG <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUcnOR: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIRISHED FLOOR ELEVATIORS: <br /> <br />FT. <br /> <br />IS PROJECI IN FLOOD ZONE AREA 1 <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BUlIJlllR U <br />Signature ~~.. _ <br /> <br />CONTRACTOR SECTION' <br /> <br />~ . /7 COMPANY J,,/ /YI ? <br />% tt->lc-/ State Cert.. or Regist. , <br />/t/ ____--z../ ---City License Registration , <br />...........*..*.********......*******.***. <br /> <br />ELECTRICIAN <br />SiRn~~~~~f?L <br /> <br />~OMPANY .t! /:)Yt. /~ <br />/ <br />~ . State Cert. or Regist. , <br />A "'Z--z-~ ity License Registration' <br />.**.....................................** <br /> <br />kZ COMPANY i(/ J/( P <br />~ / // State Cert. or'Regist. , <br />./ i _ <br />/{../ ;f/'l.../- city License Registration' <br />..........*.*..*..*..*.........*.*****.**. <br /> <br />PLUMBER & /~ ?' <br />Signature c~:-z/ <br /> <br />IlECBANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />...............*..*.............*.....***. <br /> <br />Signature <br /> <br />OTRRR <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.............*........*..*................ <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />