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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTKBtfr <br /> <br />OWNER'S IiAHE <br /> <br />('tt-IZL \TU,uov- <br />'S?d I <br />~~L ~~ <br /> <br />PHONE <br /> <br />7?f<l 36 SO <br /> <br />OWNER'S ADDIlBSS <br /> <br />I;;?r- 81 <br />tI;~~L. <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIP'lION: LOT(S) <br /> <br />B~UBDIVISION <br /> <br />PARCEL LD.t <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:__ew Coostruction ---..Addition ---^Iteration ---Repair _Install <br /> <br />_Sign <br /> <br />--.-Hove <br /> <br />---Peaolish <br /> <br />PROPOSED USE: -5ingle F_ily <br /> <br />---.Jt/F _' of Units ---.Jt/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swill. Pool _Other <br /> <br />--Restaurant &: Health Departaent Approval <br />DESCRIPTIOBOFWORK: ~ Ro/?.. ~:r)v S1.-Iti3 k /~ 16>,<(0 S~.&~ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEIITIAL: A'lTACII (2) PLOT PLANS &: (2) SETS OF BUILDING PLABS &: (1) SET ENERGY FORMS. <br />COIIHERCIAL: A'lTACII (3) SETS OF BUILDING PLABS &: (1) SET ENERGY FORHS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />-BUILDING <br /> <br />$ <br /> <br />1<6 ;)-;- <br /> <br />~ <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />RT.RcrRI.CAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---.JIEClWlICAL <br /> <br />$ <br /> <br />Valuation of Hecbanical Installation <br /> <br />---PLUKBDiG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY .' <br /> <br />TYPE OF COIS1'llUcnOIi: -Block _Fraae _Steel <br /> <br />Other <br /> <br />FIIIlSBED FLOOB. BLEVAnOliS: <br /> <br />Fl. <br /> <br />IS PROJEct IN FLOOD ZONE AREA! <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />BUTlllER <br /> <br />CONTRACTOR SECTION <br /> <br />~ ../J ..:,,' ,..~.~,' ..oom:~ S'OIJ5~ &(/I(,<tI!/l1 <br />i / 'k /;. State Cert. or Regist. , <br />.' .~, '~ City License Registration' 77 <br />.......................................... <br /> <br />Signature <br /> <br />RI.RCTRICIAlI <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />.......................................... <br /> <br />SilmAture <br /> <br />PLIDIBRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration f <br />.......................................... <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COHPANY <br />State Cert. or Regist. , <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLICAnOB APPROVED BY <br /> <br />PEBKIT OFFICER. <br />