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<br />APPLICATION FOR PBRKIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />41/1/tlAJ/1 jJu~.htr <br />'lk r;; <br />OWNER'S ADDRESS -?Rt!J/?7 /~h~ t/I! <br />5~/ <br /> <br />PHONE ZI:l- .?~1:5 <br /> <br />OWNER'S RAHK <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESClUP'I'ION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCIlL LD.' (OBTAIN flIOH J.'BOPIlBTl ~l <br />WORK PROPOSED:~ew Construction ----Itddition ---...A1teration --Jlepair __ TOAtall <br /> <br />_Sign <br /> <br />--.JIove <br /> <br />--Peaolish <br /> <br />PROPOSED USE: _Single Fsaily <br /> <br />---..J4/F _' of Units ---..J4/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />---..Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: /,.(/:5 /Ak"/ ",A/~R.J {6r.--/.t"~ <br /> <br />A&=4~/-v~ ... ~OL/;V{;; P'A.I/rs <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEIITIAL: ATTACH (2) PLOT PLARS & (2) SETS OF BUILDING PLANS" (1) SET ENERGY FORMS. <br />COHKERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~UlLDING <br /> <br />$ <br /> <br />PERMITS REQUESTED <br />Valuation of Total Construction <br /> <br />z: <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />;z;~ <br /> <br />Valuation of Mechanical Instal1.ation <br /> <br />_PLUKBIRG GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: -Block _Fraae _Steel <br /> <br />Other <br /> <br />FIIlISBBD FLOOll ELEVAnONS: <br /> <br />n. <br /> <br />IS PROJECT IN FLOOD ZONE AREA' <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />BIITlllER <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />RT.RCTRICL\II <br />SilrflAture V' <br /> <br />CotIPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />PLUKBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br />KECllANICAL <br /> <br />COKPANY Gf/iJGt'/~ A~r/-t/y ,;. C:4:Jv";(, <br />State Ceri. or Regist. . 4"-4-c."O _">/~// <br />City License Registration f <br />.......................................... <br /> <br />OTRRR <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PBRKIT OFFICER. <br />