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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRHILLS <br />BUILDING DEPARTKENT <br /> <br />OWNER' S ADDRESS <br /> <br />r~) <br />8 ~~ 51 <br />S'ifA(l.- <br /> <br />S:/fD K 5t1'f })~ PHONE <br />-r~ O-R- ~r ~ <br />.-;-Jf~f( '5 Ii 1-1 p <br /> <br />, <br /> <br />7{~ - 370 I <br /> <br />OWNER' S HAHE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOClL--SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ---^ddition ----Alteration _Repair _Install <br /> <br />_Sign <br /> <br />--.JIove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Siogle Feaily <br /> <br />-.Jt/F _' of Units _K/B <br /> <br />_ec-ercia1 <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />-:Restaurant &: Bealth Departaent Approval <br />DESCRIPnON OF WORK: l' C) / IIJ '5 I1;-cc 9 ')( .9 6 / /tV ,2;-a;:: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDEIITIAL: <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 />-BUILDING <br /> <br />$ <br /> <br />.-aU <br />/ /00 <br /> <br />PERKITS REQUESTED <br /> <br />Va1uation of Total Construction <br /> <br />RI.RcrRI.CAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---...JIEClWlICAL <br /> <br />$ <br /> <br />Valuation of lIechanica1 Installation <br /> <br />.-PL1DIBDG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF COIlS1'1lUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDlISBED PLOOB. ELEVAfiONS: <br /> <br />FT. <br /> <br />IS PROJEct IN FLOOD ZOBE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />B(ITT.DER <br /> <br />CONTRACTOR SECTION <br /> <br />~ /// COMPANY " c:;; Ij )j;.77f7~ <br />( ./ ff /l State Cert. or Regist. . <br />. -tc.. ~....... City License Registration . <br />.......................................... <br /> <br />/"tC-J ;.,- /1\J J "7' <br /> <br />'77 <br /> <br />Signature <br /> <br />RI.RCTRICIAII COMPANY <br />State Cert. or Regist. . <br />SianAture City License Registration . <br />.......................................... <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />KECBAlf[GAI. COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICAnON APPROVED BY PERMIT OFFICER. <br />