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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />7-11 *!(,5-_~-S <br />:-\ X- _r;- 'i ~ '--~- -\-l s::-f- <br />~<.: A- (V'- t <br />I (--d (P - d. , .- CD (7:;) I (0 CJ (:) CJ 0 0 ~u <br />LEGAL DESCRIPTION: LOT(S) / BLOCK SUBDIVISION <br />rJ- <br /> <br />PHONE <br /> <br />~ 1:.)- {Of ~ <br /> <br />OWNER'S NAKE <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />PARCEL I. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction ~itiOn --...Alteration ---Repair _Install <br /> ~gn ---"ove _Deaolish <br />PROPOSED USE: Z Faally ---"IF _' of Units -1I/H <br /> ec-ercial _Indust. _Swia. Pool _Other <br /> <br />---Restaurant & Health Depar~ent Approval <br /> <br />DESCRIPTION OF WORK: W ~ l' (f> f 7 f"^'- S " S~) + 1\ 'T f'v'- <br /> <br />BUILDING SIZE: -SlL-x G .~ Square Feet, I ~ 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 />PERMITS REOUESTED <br /> <br />_BUILDING <br />~CTRICAL <br /> <br />$ -3 cTZ) <br /> <br />/J(1 <br /> <br />'---0 <br /> <br />Valuation of Total Construction <br /> <br />AtIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----"ECllAlllCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUKBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: _Block _Fr_e _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 />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />COMPANY <br />State Cert. or Resist. . <br />City License Registration . <br />***********........*********************** <br /> <br /> <br />~~ ~~ ~~I~,f <br />. .. State Cert. or egist.' l?C 000 <br />City License Registration . <br />**** ********************************* <br /> <br />Signature <br /> <br />:=~;11 JJA <br /> <br /> <br />, <br /> <br />/Cf'l~ <br /> <br />PLUKBER <br /> <br />COMPANY <br />State Cert. or Resist. . <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />IlECHANICAL <br /> <br />COMPANY <br />State Cert. or Resist. . <br />City License Registration . <br />*****************.****.******************* <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****~********************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br /> <br />PERMIT OFFICER. <br />