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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />~ <br /> <br />1~( f%.~'lt.q1 <br />;r1~ <br /> <br />OWNER'S NAHEHilfhOfl~ '1, q... ma.r-VCid17 fY7arr-el/cJ PHONE q/J'.,.. 9L/r-6oL/~ <br />OWNER'S ADDRESS d.!j 35...5 +4),' r1 [qkeS' LOI'I~/ C) / ({'",'/~e:S f:L, :5 ~/0S ~ <br />JOB ADDRESS La i 9 nfJ RI-;; I Ci' k P [)RI'f-/~ 7e /,'/~ t( ;:1/','//<; <br />L' / 0 <br />OJ- / <br /> <br />BLOCK <br /> <br />SUBDIVISION Sfl"/JIl eElS" '-11"/7 'S,/l/toR O,41:::s <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL I. D.' 03.,J&:., - () I - () /5 () - 00 DOO - 0 096 (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED: ~w Construction _Addition ~lteration _Repair _Install <br /> <br />_Sign <br /> <br />--"ove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: VSingle Faaily <br /> <br />_M/F _' of Units _M/H <br /> <br />_~ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: 11 e LV ~..()n'Sj. r uc-i.. ;0/1- 5,' r1fJl E Fc:UV7" II' K,p c::; /,./~/I'C --e <br /> <br />(j F.ee+ <br />BUILDING SIZE: S.2. '1 X ~O, 1 . <.''Jj3 ~ I) Square Feet, / 0 Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />/ <br />2:-BUILDING <br /> <br />$ <br /> <br />(l(1 <br />) 7, 9{j 0 - Valua/:f Total Construction <br />AMP Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_ELECTRICAL <br /> <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_MECHANICAL <br /> <br />_PLUMBING <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRucnON: <br /> <br />Fraae _Steel <br /> <br />Other <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />-******************************* <br /> <br />CONTRACTOR SECTION <br /> <br />glJ~ '11(- 91/1/7 <br /> <br />COMPANY l.t.)" f"I c:t Q f\'1 JIll e U 1-/0 m e b~' I d 'fJ Il :s <br />State Cert. or Regist.' L/ fcJ 7 '/ <br />City License Registration . cD-9"7 <br />************************** <br /> <br />V'/ <br /> <br />COMPANY <br />State Cert. or Regist. t <br />~ City License Registration . <br />****************************************** <br /> <br /> <br />1../" <br /> <br />PLUMBER <br />Signatuf <br /> <br /><:, .- , <br />COMPANY ..~ I ~ n"j C< n e Y\ 1::. r1 +-er- er-r S -e ~. <br />State Cert. or Regist. . f<. 1= ,F) I '-fer <br />ity License Registration' /70 <br />****** ************************ <br /> <br />(11d. <br />I. /l c. . ,0td. <br /> <br />COMPANY ,::J'e hl.v\ " +T) J () C . <br />State Cert. or Regist. , ",J)() ~~ <br />City License Registration . <br />****************************************** <br /> <br />V'. <br /> <br />COMPANY Aa..- I J I,' P k06 (';- ';q ~O;5~/C:/I'O~J.-a=. <br />mClil 0 State Cert. or Regist. , ;l C; 0 q . <br />4~_d ) City License Registration' ~' . <br />****************************************** /~ <br /> <br />APPLICAnON APPROVED BY ':11 t.lMA'1 m MJ-'-}:j <br /> <br />OTRRR <br /> <br />'~ <br />Signatur . 1U\nQ <br /> <br />PERMIT OFFICER. <br />