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<br />, , <br /> <br />1 <br /> <br />APPLICATION FOR PERKIT <br />Cln OF ZEPHYRIIILLS <br />BUILDING DEPARntEBT <br /> <br />JJ~ ()\J rn;/ \ <br /> <br />5' U M hli2-r A 'j { } <br /> <br />20 <br /> <br />OWNER · S NAItE <br /> <br />SummQr"- <br />~9 <br />5) ~ S <br /> <br />WI <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />PARCEL LD.' <br /> <br />/2-J 2-<;; /2- <br />I I <br /> <br />l--tu <br /> <br />rn..Q ) <br />La-I"\P <br /> <br />PHONE 7~( 2. - 2- 7 5 '3 <br /> <br />Dr- <br /> <br />BLOCK <br /> <br />)vrnMJv-h: LJ <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED:_Nev Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />PROPOSED USE: <br /> <br />Single FUlily <br /> <br />_ec-ercial <br /> <br />_Hove <br /> <br />_De.olish <br /> <br />_"'F <br /> <br />_' of Units <br /> <br />_"'H <br /> <br />_Indust. <br /> <br />XSvia. Pool S'rrp()." FAcI,o<,'-'~ Other <br /> <br />BUILDING SIZE: <br /> <br />_Restaurant 6: Health DeparUlent Approval <br /> <br />x <br /> <br />~uare Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COfItIERCIAL : <br /> <br />ATTACH (2) PLOT PL.AftilIS 6: (2) SKIS OF BUILDING PLARS 6: (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLMiS 6: (1) SET ENERGY FORItS. <br />PROPERTY SURVEY REQ1JIRED FOR ALL NEW CONSTRUCTION. <br /> <br />_BUILDING <br /> <br />$ <br /> <br />_ELECl"RlGAL <br /> <br />AKP Service <br /> <br />_KECllAliICAL <br /> <br />$ <br /> <br />_PLlJPIBING <br /> <br />GAS <br /> <br />PERKITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />Valuation of Mechanical Installation <br /> <br />ROOFIJiG <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />TYPE OF CONSTRUcrrON: _Block _FrUle _Steel <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />......................*.*..*.............. <br /> <br />YES NO <br /> <br />COlITRACI'OR SECI'ION <br /> <br />COItPANY ()/~ OJ bi/J J 12ee/ ptJ~!r .L <2 <br />State Cert. or Regist. t CPC 0-1 ~ 7'/6' <br />City License Registration t -# ~ L <br />............*............................. <br /> <br /> <br />BUILDER <br /> <br />SiPf1~ture <br /> <br />Q~ \ \~ <br /> <br />COKPANY C 1"\.:. -. -J- L i ......, <br />State Cert. or Regist. t ~ Roo J "3 0 4 0 <br />City License Registration t 7- 7 ~ <br />.......................................... <br /> <br />ELECTRI <br /> <br /> <br />PLutlBER <br /> <br />J:=-- Lz c + <br /> <br />COKPANY <br />Stat.e Cert. or Regist. I <br />City License Registration t <br />.......*.................................. <br /> <br /> <br />!tECllARICAL <br /> <br />Signat.ure <br /> <br />COKPAIiY <br />State Cert.. or Regist.. t <br />City License Registration . <br />.........*..........*..................... <br /> <br /> <br />OTHF.R <br /> <br />Signature <br /> <br />COKPANY <br />Stat.e Cert. or Regist. t <br />City License Registration t <br />...................**...*........... <br /> <br /> <br />1,7 <br /> <br />PERKIT OFFICER. <br />