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<br />APPLICATION FOR' PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER'S NAHE <br /> <br />4dA'~ &mS;/" I!;;t/~~ <br />I?AAtV(!L:f <br /> <br />PHONE )//3 -782,-2,.2-7-6 <br />4, k/,i~A. ;(;//s.i;c.?,4 =?3.r14:J <br /> <br />OWNER'S ADDUSS ~M':;pJ 3q 7B S- <br />JOB ADDRESS S~ lJ-r/lJ~.s <br /> <br />LEGAL DESCRIP'lION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />PARCEL I. D.' d '/ - .;l Co . c;;J/ - LJt7C:70 - t?t1 /0 - ttJ() SO <br /> <br />WORK PROPOSED:~ew Construction ---..Addition -J\lteration --Repair ~Insta1l <br /> _Sign ---lIove ->>eaGlish <br />PROPOSED USE: _Single Fsaily ---lI/F _' of Units ----11/8 <br /> ...2l:...eo-ercial _Indust. _Swia. Pool _Other <br /> <br />Restaurant &: 8ealth Departaent Approval <br />DESCRIPTIOR OF WORK: 5~ tA. JI) I '1.,c.. (3&'&" /JtO()u 01-~ UAr/-- <br />. <br /> <br />BUILDING SIZE: /~ X 6!'f," 9~ Square Feet, 154'l1.iUIeight <br /> <br />RESIDENTIAL: ATtACH (2) PLOT PLARS &: (2) SETS OF BUILDIRG PLANS &: (1) SET EBERGY FORMS. <br />COMMERCIAL: ATtACH (3) SETS OF BUILDING PLANS &: (1) SET ERERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />-=;LaUILDING <br />k. RT.RCl'RICAL <br />~CIIAlII.CAL <br />~UKBIRG <br /> <br />PERMITS R.EOUESTED <br />$. 33 ~ 1"z,o Valuation of Total Construction <br />/50 AHP Service ~ Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$. 1.306 <br /> <br />Valuation of lIecbanica1 Installation <br /> <br />GAS <br /> <br />ROOFIRG <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUCl'IOR: ----=:.Block --=--'raae =--Steel /2JtJiJt{ t:.H'"A- Other <br />FIBISBED FLOOR. ELEVAfiORS: ,1)/4-- Fl. IS PROJECT IN FLOOD ZONE ARBA"l <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BIJTT.DRR <br /> <br />Sipatv.re ~ <br /> <br />CORTRACTOR SEctION <br /> <br />COHPAIJY#;'/l ~~.~ ~ <br />/ State Cert. or Regist. . <br />~ City License Registration' PII -106 l/7 <br />.......................................... <br /> <br />"'.RCTIIICIAII ~ COIfPMJY <", N . =~ <br /> <br />~;=~~ ~-<--i.~ s~~eL:;..o~:~:~~ . <br /> <br />~ .. ....................................... <br /> <br />~ <br /> <br />5K <br /> <br />PLUHBER <br /> <br />Signature <br /> <br />/VbIVC <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />1lEClWlIC4J. ~ COIfPMJY :8""11"" <br />State Cert. or Regist. . <br />Signature ~~~ 4~ City License Registration' <br />.......................................... <br /> <br />1Y79 <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLlCAnOR APPROVED BY PBRHIT OFFICER. <br />