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<br />APPLICATIOR FOR PERMIT <br />CITY OF ZEPBYRHILLS <br />BUILDIRG DEPARTHERT <br /> <br />OWNER'S RAME h, JJePd t. a~.I9N (. <br /> <br />OWRER'S ADDRESS 6Jf~1 04-~-<- 13:>. <br /> <br />.Q7t2/ C;.-9~L S, &P~'/~4I'LL-G,.,c-L--' <br />~ 4rrAC!~b . . , <br />LEGAL DESCRIPTIOR: LOT(S) BLOCK SUBDIVISIOR <br /> <br />PARCEL 1.D.# /1- ;;If:, - ;L/ V?:l- /'1-::2tJ -d/'-.;)~ /:J /70BTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:__ew Construction ----^ddition ./ Alteration ____epair _Install <br /> <br />IY) ,D . PHONE <br />Zept<lu.#{l-~~ <br /> <br />71' J? - rs- c:2 </ <br /> <br />JOB ADDRESS <br /> <br />_Sign <br /> <br />-.JIove <br /> <br />->>eaGlish <br /> <br />pmPOSED~E: _S~eF_ily <br />~erCial <br /> <br />---l4/F _# of Units _K/H <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />____estaurant &: Health Departaent Approval <br />DESCRIPTIOR OF WORK: ]?.eY~'.4~ a-rf-rr~1"J < > ..$tVo/l &C!.-T <br />, <br /> <br />BUILDIRG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEBTIAL: A'n'ACH (2) PLOT PLANS &: (2) SETS OF BUILDIRG PLANS &: (1) SET ENERGY FORMS. <br />COMMERCIAL: A'n'ACH (3) SETS OF BUILDIRG PLANS &: (1) SET ERERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~UILDIRG <br />~ ELECTRICAL <br /> <br />PERMITS REOUESTED <br />. "0 <br />$ f 500 - Valuation of Total Construction <br />#~'1-c:Nti1iJ'~/6r /(91175,.,.4J>. ~ ,(kep, <br />Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---llECIIAlIICAL <br /> <br />$ <br /> <br />Valuation of tlechanical Installation <br /> <br />_PLUKBIRG GAS ROOFING <br />TYPE OF CORSTRUCTIOR: _Block _Fraae _Steel <br /> <br />SPECIALTY ' <br /> <br />Other <br /> <br />FlIJISBED FLOOR ELEVAnORS: <br /> <br />Fl. <br /> <br />IS PROJECT IR FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />I <br /> <br />CONTRACTOR SECTION <br /> <br />w~ . cm:AIIr $'(]v,~"..JHO' -MDC,..7;;C. <br />.. State Cert. or Regist. # C oc:...3 '5 <br />Signature~~" City License Registration # <br />~ .......................................... <br /> <br />BUTI.DRR <br /> <br /> <br />r <br /> <br />RT.RCTRICIAII <br />/{":' <br />SilmAture' ~ tr-;}o--., <br />v <br /> <br />~ COHPARY A ->,1. ~ 'j ~ r. A ~ ~ t7 ~<;r;;, ; f;^ 11 L~ ,-;) <br />-\ ""'0 J, / State Cert. or Regist. # k /~ ~~D'72 I.. ~ <br />'i!. t 'Av f ~.i....-', City License Registration # _ <br />.......................................... <br /> <br />PLUMBER <br /> <br />COtIPARY <br />State Cert. or Regist. # <br />City License Registration # <br />.......................................... <br /> <br />Signature <br /> <br />tlECBANICAL <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />.......................................... <br /> <br />Signature <br /> <br />. m1IBB <br /> <br />COMPARY <br />State Cert. or Regist. # <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />APPLICAnON APPROVED BY <br /> <br />PERMIT OFFICER. <br />" . <br />