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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />1/5?~_::,( {? - c2. 3 -7J1 <br /> <br />---- /' <br /> <br />OWNER · S ADDRESS <br /> <br />Fqs-f- ~jC 0 ~5 ro Y\ Wheeb <br />,)gli~&) -' //3B ,i);~ <br /> <br />PHONE <br /> <br />7%0;- 7851 <br /> <br />OWNER · S NAKE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) ----- BLOCK SUBDIVISIMf <br />PARCEL 1. D. tJ - ~ (0 - ~l - 00 { 0 ~ t>O~ - QJ? 0 (OBTAIN FROK PROPERTY TAX NOTICE) <br />WORK PROPOSED:~ Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Si~e Faaily <br />~ercial <br /> <br />_K/F <br /> <br />_, of Units _K/H <br /> <br />_Indust. <br /> <br />_Swim. Pool _Other <br /> <br />_Restaurant & Health DeparbBent Approval <br /> <br />DESCRIPTION OF WORK: A~lJM Pat; 0 Cwer <br />t::l ' 1 I.../. I r <br />BUILDING SIZE: --=-I--X-1..Ll2... '-//1 Square Feet. /0 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 />~UILDING <br /> <br />$ <br /> <br />C/O <br />?SOD - <br /> <br />PERMITS REOUESTED <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 />-"ECHAIflCAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _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 />Signature <br /> <br />CONTRACTOR SECTION <br /> <br />i4 ~ ~ a>>IPAIIY-&hr'~ -M~;V\tJ12[~ <br />State Cert. or Regist. t t... '();/t. t) <br />~, 'f!IZ rJl4J2 City License Registration t tV gt'j <br />*****.....~**************.************ <br /> <br />Ur- ) <br /> <br />BUILDER <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration , <br />**..*...*****..***********..************** <br /> <br />SismAture <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration t <br />**.***.****************.****************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. * <br />City License Registration t <br />*****.*******************.**************** <br /> <br />Signature <br /> <br />OTRRR <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />******.**************.*******.*.********** <br /> <br />APPLICATION APPIIOVED BY ,J1 ~ J11 ""P-~ <br /> <br />PERKIT OFFICER. <br />