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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTKERT <br /> <br />.--z:rJ'J I-- / 0 / 0 _I y- 5i'~ . . <br />T IT ,- f<:;: < c/D <br /> <br />OWNER'S tWIE T'(.~ NJ /lh.4~e-: /2 ell~,~~ PHONE 7cB Z- - dOlo '7 <br />OWNER'S ADDRESS Z 73b '- I!>~(IJ J.f,'11 !lJ. 2~ru;lwns, ~ :5l PlI <br />JOB ADDRESS~2 31 S~lu~' O~ /.Jy"Vi-,; Z~;""I./f1s, ~~ ~ l~rl <br />LEGAL DESCRIP'l'ION: LOT(S) I s ~ :r: SUBDIVISION' s,J~ tJ4-~ <br />PARCEL 1.0.' D?:. - 21- - ZI - (!) J 2..11-- 0000<)- () 160 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:,>>ew Construction ---..Addition --Alteration --,epair _Install <br /> _Sign ----.Jlove _Deaolish <br />PROPOSED USE: ..xsiogle Faaily ---.Jf.1 F _' of Units _K/H <br /> _ec-ercial _Indust. _Swia. Pool _Other <br /> <br />--,estaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: ~,~/- ~~,1, C(.lJ).o~ ~/J~..b{ ~~ <br />r: 7J TiN \7 J f'/~ <br />BUILDIRG SIZE: .:> 7 x..s . 2-Z7,1 Square Feet, ~ Height <br /> <br />~~ ATTACH m PLOT PLANS &.llL SETS OF BUILDING PLANS & ULSET ENERGY FORMS. <br />: ArlACII (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />KsUILDING <br />X RT.RCTRICAL <br />~CIIAlIICAL <br />~PL~~G <br /> <br />P -?t) Ou':::"~ <br />$ /' / Valuation of Total Construction <br /> <br />2,.0-.> AIIP Service X Florida Power Corp. <br />S !I Sl>DD- <br /> <br />PERMITS REOUESTED <br /> <br />W.R.E.C. <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />TYPE OF COlISTRUCTION: KBloclt _Fraae _Steel <br />I <br />FIIIlSHBD FLOOR BLBVAfiONS: g D Fr. <br /> <br />X ROOFING <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />YES <br /> <br />X. <br />NO <br /> <br />IS PROJEC'l III FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br /> <br />/ <br />'. <br /> <br />RIJTT.DRR ''/ ~ ~ <br /> <br />Signature ~ C City L cease Registration . <br />- ****************************************** <br /> <br />RT.RCTRICIAII <br />Si--tuu Q~ <br /> <br />~~ <br /> <br />"- r/~~ <br />State Cert. or Regist. . 'It <br />City License Registration . <br />****************************************** <br /> <br />COMPANY <br /> <br /> <br />PLDKBER ~ COMPANY ~~40\U ~l\.\h1~tn~ / <br />1\ (I rY'i. State Cert. or Regis t.' ~ C 4d.. 9 q 5'0 . <br />Signature ~ IJ Y _ \3J..JW~ City License Registration' Il11 .2 9 <br />****** ******************************** <br /> <br />1lEaWlICM. COIIPARY ~~ HEAr~c Jt~~ ~'0, . / <br />State Cert. or Regist... Z) ~ <br />City License Registration' _ ~2V <br />********************************** <br /> <br /> <br />11--/ ft..)/-.., , ~ <br />, <br /> <br />PERKlT OFFICER. <br />