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<br />"rv~{.../ r fb-tc.e-.- ~~. <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME <br /> <br />:5{.,uJ~J ~IL-- <br /> <br />PHONE q O<{J- t.JV -.s-G~ 1 <br /> <br />JOB ADDRESS <br /> <br />OWNER'S ADDRESS <br /> <br />~3tfS- <br /> <br />G;-ML ~LI j) <br /> <br />-t: ~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />I <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />~ <br />du- <br /> <br />~(*--D <br /> <br />PARCEL 1.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED :_New Construction _Addition _Alteration _Repair ,.2s;LInstall <br /> ~Sign _Move _Deaolish <br />PROPOSED USE: _Single F8Ilily _KIF _' of Units _M/H <br /> _CoI8ercial _Indust. _Swill. Pool _Other <br /> <br />BUILDING <br /> <br />~CAL <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 />/OltrV - <br /> <br />$ ~OO ~ <br /> <br />PERMITS REOUESTEQ <br /> <br />Valuation of Total Construction <br /> <br />AtIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECIIAlUCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />Fl' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA'l <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />BUIIJ)ER . <br />) <br />Signatu'r~ <br /> <br />mliTIlA=::E~TliM-o Tt-ILS'~ ~ <br /> <br />n~mtt State Cert. or Regist. . <br />l~~ . City License Registration t <br />******** ~**** *************************** <br /> <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration , <br />****************************************** <br /> <br />Sisma.ture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />OTHF.R <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />APPLlCArtON APPROVED By)1 aAvt'~ IN ~ <br /> <br />PERMIT OFFICER. <br />