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<br />APPLICAnON FOR PERMIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAME <br /> <br />a .-v'...-vl J <br /> <br />OWHER' S ADDRESS <br /> <br />5 8 Y;1 '") <br />38Y~} <br /> <br />h/\J4 ( [) <br /> <br />/9<..../ c= <br /> <br />Au~ <br /> <br />PHONE 7/12 - ~ -s L ~ <br /> <br />JOB ADDRESS <br /> <br />c- <br />C <br /> <br />LEGAL DESCRIPrION: LOT(S) <br /> <br />BLOC1L...-SOBDIVISION <br /> <br />PARCEL l.D.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~ew Construction ~ition --..Alteration -Jepair / Install <br /> <br />_Sign <br /> <br />-.JIove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />----.Jt/F _' of Units ----.Jt/H <br /> <br />_ec:-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />___..Restaurant &: Health Departaent Approval <br />DESCRIPTIOB OF WORK: h/CL ~~/:)j-('SS/(l/tJ /N <br />, <br /> <br />kyf4C"N ~11 <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />. <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDEBTL\L: <br />COMMERCIAL : <br /> <br />AT'J.'ACII (2) PLOT PLABS &: (2) SETS OF BUILDING PLANS &: (1) SET EBERGY FORMS. <br />AT'J.'ACII (3) SETS OF BUILDING PLANS &: (1) SET EBERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW COBSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />-BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RT.RCTRICAL <br /> <br />~CAL <br /> <br />$ <br /> <br />AIIP Service Florida Power Corp. <br />{Y0 <br />/ / 0 (J ,- Valuation of Mechanical Installation <br /> <br />W.R.E.C. <br /> <br />_PLUtlBING GAS ROOFIBG <br /> <br />SPECIALTY <br /> <br />TYPE OF COBSTRUCTIOB: _Bloclt _Fraae _Steel <br /> <br />Other <br /> <br />FIJlISBBD FLOOR ELEVAnOBS: <br /> <br />Fl. <br /> <br />IS PROJEct' IN FLOOD ZOBE AREA? <br /> <br />YES NO <br /> <br />..........*****..**..*....**************** <br /> <br />COBTRACTOR SECTION <br /> <br />RIJTT.nn <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />*******************************.********** <br /> <br />Signature <br /> <br />RT.RCTRICIAR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />..*...*.*.***************.****.*********** <br /> <br />SionAture <br /> <br />PLDHBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />....**************.*****.***.************* <br /> <br />Signature <br /> <br />IlECBANICAL <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />/******.***************.*..********.***** <br /> <br />COMPANY '/J1 t' L /-9 L H /lA.- <br />State Cert. or Regist. . <br />~ City License Registration , <br />***********************.********** <br /> <br />Signature <br /> <br />OTRF.R <br /> <br /> <br />Signature <br /> <br /> <br /> <br />APPLlCATIOB APPROVED BY <br /> <br />PERMIT OFFICER. <br />