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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPAR'l'HENT <br /> <br />//;JvrL M,c/~(UfJ,P/rH#! <br />.r/<"?f~~~ <br /> <br />'I; ()(( <br />1'>1.,......./ <br /> <br />JOB ADDRESS <br /> <br /> <br />HONE <br /> <br />7Z:J -- [JO.~5 <br /> <br />OWNER' S <br /> <br />OWNER' S ADDRESS <br /> <br />r-K- <br /> <br />LEGAL DESClUPTlON: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br /> <br />--Addition ----Alteration --.Jlepair _Install <br /> <br />WORK PROPOSED: <br /> <br />_Sign <br /> <br />---"<>ve <br /> <br />-DeIIOlish <br /> <br />! <br /> <br /> <br />PROPOSED USE: _~e Faaily <br /> <br />~/F <br /> <br />_' of Units ~/B <br /> <br />_ec-ercial <br /> <br />BUILDING SIZE: <br /> <br />'-- <br /> <br />x <br /> <br />RBSIDBIITL\L: <br />COHKERCIAL : <br /> <br />AtTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET DERGY FORMS. <br />ATlACII (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~UG <br /> <br />$ <br /> <br />.. . W PERMITS REQUESTED <br />I d 1 () ~. Valuation of Total Construction <br /> <br />RT.RcrIUCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---1IECBAIIICAL <br /> <br />$ <br /> <br />Valuation of Hechanica1 Installation <br /> <br />-YLUHBIBG GAS ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPE OF OOIISD.UcnOR: ___loclt _Fraae _Steel <br /> <br />Other <br /> <br />FIllISBED FLOOR. ELEVAnORS: <br /> <br />FT. <br /> <br />IS PROJEct III FLOOD ZONE AREA., <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BUTT.DER <br /> <br />. .' CONTRACTOR SECTION <br />. .' · . &b' .} fJ1 I <br />W ~: .. . oociPAIIY . 1""> . VrY) IVJ,U YV) <br /> <br />~ . State Cert. or Regist. . CDC'B~ fY77 <br />. ~. . . City License Registration . 5 <br />~" , ......~........................... ~ <br /> <br />Signature <br /> <br />RI.RCTRICIAR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License R.egistration . <br />.......................................... <br /> <br />SiRIIAture <br /> <br />PLUHBER <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />IlECllARICAL <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration f <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 />PERKIT OFFICER. <br />