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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S RAHB CJJ9rkS /1T~~ <br />OWNER'S ADDUSS 3 ~ q 39-- t)7Ji /f,.e. <br />~~ <br /> <br />PHONE <br /> <br />JO~ ADDRESS <br /> <br />BLOCK/fr;rsOBDIVISIollG;~[j f1~;f-~- <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />LEGAL DESCRIPl'ION: LOT(S) !c1..f /3 <br /> <br />PARCEL I. D. f <br /> <br />WORK PROPOSED:~ew Construction .--.Addition .-Jlteration _Repair _Install <br /> _Sign ~ve _Deaolish <br /> / ---Yt/F _' of Units ---Yt/H <br />PROPOSED USE: _Single Faaily <br /> _~rcial _Indust. _Swia. Pool _Other <br /> <br />--Restaurant &: Health Departaent Approval <br />DESCRIPTION OF WORK:~s/;H1 9r/PJ ~ 7e IJ({) ~ <br />BUILDING SIZE: X Square Feet, Height <br /> <br />RESIDEHTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />~UlLDING <br /> <br />$ <br /> <br />~/)50. t:,o_ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power CQrp. <br /> <br />W.R.E.C. <br /> <br />----"ECllAlfiCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FlllISBED FI.OOR ELEVAnONS: <br /> <br />Fl. <br /> <br />IS PROJECt IN FLOOD ZONE AREA! <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CORTRAC'l'OR SEC'l'ION <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />.......................................... <br /> <br />BUTT.DER <br /> <br />Signature <br /> <br />RT.RCTRICIAR <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration , <br />.......................................... <br /> <br />Siooature <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />.......................................... <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration f <br />....***.**......*........*.....*.......... <br /> <br />OTRF.R ?f~N(e. COMPANY a~ ~I 7f:~' . <br /> <br />~,M State Cert. or Regist. f 'l!.eJlb/'77~ <br />Signatur [}[)f;it6- City License Registration f 4;8::;' <br />.......*........*.....*..*......*......... <br /> <br />APPLICAnON APPROVED BY <br /> <br />PERKIT OFFICER. <br />