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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPHYRIIILLS <br />BUILDING DEPARTtlENT <br /> <br />OWNER'S NAHR <br /> <br />l)o~\j1<L tJ -.L ~y<:"€... (dJqllfl6W <br />,S-r'J 4c -'<-- <br /> <br />PHONE 76'.3 ---/'S/o <br /> <br />OWNER'S ADDRESS 3q ~ \.( ~ <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />OWCR <br /> <br />SUBDIVISION <br /> <br />PARCEL 1.D.' I~':'" '~Co -J.-., e>C:N,(j 005"00 001 a <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:____New Construction ----Addition ----^lteration ~epair ____Install <br /> <br />____Sign <br /> <br />---1Iove <br /> <br />_D~olish <br /> <br />PROPOSED USE: .:.--Single F$IIily <br /> <br />---1I/F _' of Units ....-HIH <br /> <br />_ec-ercial <br /> <br />_wdust. _Swill. Pool _Other <br /> <br />~estaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PWT PLANS & (2) SETS OF BUIlJ)ING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEN CONSTRUCTION. <br /> <br />PERHlTS REQUESTED <br /> <br />~UILDING <br /> <br /><::>0 <br />$ /3'1';;' <br /> <br />Valuation of Total Construction <br /> <br />~LECTRlCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />N.R.E.C. <br /> <br />---1IECHAIIlCAL <br /> <br />$. <br /> <br />Valuation of Mechanical Installation <br /> <br />--YLutlBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ----Block _Fr_e _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PRO.JECl IN FLOOD ZONE AREA'l <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />Signature <br /> <br /> <br />GP'TR4GJOR SECTION <br />d ----' I} ^ <br />cotIPANY ; '0..( ( c~ 6 U(/ \ <br />State Cert., or Regist. . CflLo~n '" v <br />City License Registration' ~.;) u <br />.......................................... <br /> <br />.. <br /> <br />BUILDER <br /> <br />ELECTRICIAN (\ <br />~/, . <br />SignAture .JU./l'hA /~ <br /> <br />COMPANY j) c:'ivi'vl '., 'laz. N N L{ ~ I <br />'\r ~ State Cert. or Regist.' (. 1 <br />\ /'2:7; City License Registration' <br />, ......................................... <br /> <br />be -c:c. 6: '1.f. <br /> <br />PLutlBER COMPANY <br />State Cert. or Regist. . <br />Signature ~ City License Registration . <br />.......................................... <br /> <br />COHPANY--1d Ct '-1.-< (-<'7 /f-Ji~ '-, '- ' . <br />State Cert. or Regist. . ~ <br />Signature City License Registration . <br />........................................ <br /> <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICATIOH APPROVED BY PBRHlT OFFICER. <br />