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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPAR'1'HENT <br /> <br />OWNER'S NAME <br /> <br />p OJ..J I'J.- 1) <br /> <br />OWNER'S ADDRESS <br /> <br />Yb'l2- <br /> <br />p~ <br />l3~ eJ. <br />7 K ~A/. <br /> <br />PHONE "8 /3-78'i5 -9979 <br />~~'PL 7-f-, <br />~~/O ~jfA "9L- <br /> <br />JOB ADDRESS . 83 ~13 7 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCIL--.SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction ---^ddition -..Alteration ---..Repair _Install <br /> <br />_Sign <br /> <br />---.JIove <br /> <br />->>eaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />---1f/F _' of Units _K/B <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant &: Bealth Departaent Approval <br /> <br />((~ <br /> <br />Square Feet. IO'12-Beight <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />ArlACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />_BUlLDIliG <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---1IEClWllCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUHBIliG GAS J'>(" ROOFING <br />TYPE OF COIlfSTRUcnON: ----..Block X Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FIlIISHED FLOOR ELEVAfiOIlfS: <br /> <br />Fr. <br /> <br />IS PROJEct IIi FLOOD ZONE AREA? <br /> <br />~ <br />YES NO <br /> <br />****************************************.* <br /> <br />CONTRACTOR SECTION <br /> <br />RIITT.DER. COMPANY <br />\v~ /J ~ State Cert. or Regist. .------- ~/ <br />signature~4.-~~ City License Registration .~/ ___ <br />****.*******....**......*******.*.**....*. <br /> <br />F.T.RC'l'RICIAN COMPANY <br />StateCert. or Regist. , <br />SiDnAture City License Registration . <br />***************.*....*...******...*.*...** <br /> <br />PLUHBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration f <br />****************************.************* <br /> <br />OTIID COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />***************.****************.********. <br /> <br />APPLICATION APPROVED BY PERHIT OFFICER. <br />