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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAKE <br /> <br />PHONE <br /> <br />OWNER' S ADDRESS <br />JOB ADDRESS :3 P () '3 'f d ~ ~~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />~r <br /> <br />BLOCK .. DIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ----.J.lteration _Repair _Install <br /> <br />_Sign <br /> <br />~ove <br /> <br />_DeIIOlish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />~/F <br /> <br />_' of Units _K/H <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant &: Health Departllent Approval <br /> <br />DESCRIPTION OF WORK: <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 />PERKITS 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 />--1IECIWIlCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF COIiSTRUcnOR: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDiISHED FLOOR ELEVAnONS: <br /> <br />Fl. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />..................................******** <br /> <br />CONTRACTOR SECTION <br /> <br />RIITI.DER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.*..*..................................... <br /> <br />~ ~ COKPMlYvErrf:Jl1AIJ :s,~s'tE~ <br />C State Cert. or Regist. . <br />.. \ City License Registration . v"""" / '=> ( <br />....................*.*.............*..... <br /> <br />Signature <br /> <br />COMPANY Vr <br />State Cert. or Regist. . <br />City License Registration . ~ <br />.......................................... <br /> <br />PLlJKBER <br /> <br />COMPANY f!JUI'}Q)NMiStJTI[-L- (Q~IV' . <br />State Cert. or Regist. . <br />Signature City License Registration' ~4f <br />........................... <br /> <br /> <br />OTRIT.R COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />