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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRHILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER'S IWIILt~ ~"" (0){\&\A. \4-u"Jfr ~U~S --:I ~ <br />'" <br /> <br />OWNER '5 ADDUSS'Sq \ D ?, f\D1:aLtC ~ \ ~ l~ <br />\ <br />JOB ADDRESS l:tr2..'; C<2~~(L er cl& 't", S~~e s <br /> <br />PHONE 9l"S-lblS <br />t~t\~ l I r-~ L :S~~l(O <br />\ -~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL I.D.,IJJ- ~ 6 ~ J ( <br /> <br />BLOClL-SUBDIVISION <br />(!J cJ ~ () - (J U / c7 tJ '- 6J tJ ~ f) (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction -Jddition ~teration --..Repair _Install <br /> <br />_Sign <br /> <br />-.JIove <br /> <br />-Deaolish <br /> <br />PROPOSED USE: ~iDg1e Faaily <br /> <br />---.Jt/F <br /> <br />_, of Units ---.Jt/H <br /> <br />-4ec-erCial _Indust. _Swia. Pool _Other <br />-.Jlestaurant &: Health Departaent Approval <br />DESCRIPTION OP WORK: T J'-I It- e l - IJ I'.... i2 t PJ lJ dE' / I' J--' 9- <br /> <br />BUILDING SIZE: ,.s;- 0 X I a. (.l , <br /> <br />Square Peet. <br /> <br />Height <br /> <br />RESIDERTIAL: AT'lACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. <br />COMMERCIAL: AT'lACH (3) SETS OP BUILDING PLANS &: (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~UlLDING <br /> <br />otJ_ <br />$ ~ ..s- t:) ~-- <br /> <br />PERKITS REQUESTED <br /> <br />Valuation of Total Construction <br /> <br />RI.RCTRICAL <br /> <br />AIIP Service <br /> <br />Plorida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---"ECHAlIICAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OP CONSTRucnON: _Block _Praae _Steel <br /> <br />Other <br /> <br />PIllISBED FI.OOll ELEVAfiONS: <br /> <br />Fl. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />.mUla. /! t(- <br />Signature 0--" <br />J <br /> <br />-~ <br /> <br />CONTRACTOR SECTION <br /> <br />, COHPABY 0d ;( J-- ( " I.. " s: /-' ~. . -i 4. G tJ ,. ~.(" -/' <br />~-/e~tP7 State Cert. or Regist. ,_ <br />~4--'.. City License Registration' -* be') <br />.......................................... <br /> <br />7 l <br />RI.RCTRICIAR ,/1, COMPANY k/ (. Ii A,11. tJ C e A./II1.1 ji-e. i ;FL e < rL! i'rlf L ~ 1t/ T . <br />'./ / ~ /7 State Cert. or Regist. , <br />SiItnAture&",t>tU~,./( {,,'-t/i/~^~(jJ City License Registration' a~Yo <br />.......................................... <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. f <br />. Signature City License Registration , <br />.......................................... <br /> <br />IlECllANICAL COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration . <br />.......................................... <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLICAfiON APPROVED BY PERKIT OFFICER. <br />