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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE fJtl-s.c..o fkdi,::~.J Arts Ce.~kr-Il-t~cr~"i{:i PHONE 7 Y31 t66 <br />OWNER'S ADDRESS JIb/I{ ~I'~ Ce....~tJ.v.c.. J "2~jtL.c.rAltls J R- <br />, <br /> <br />"38'tJ3S m~/W ~~a.VC-r Z4~A;J'sJI1~ 11s"~(j <br />. <br /> <br />LEGAL DESCRIPTION: LOT(S) ~ ~ '/ BLOCK SUBDIVISION I'~~(:C Wv:J;CA.I <br />rr~'#=N <br /> <br />JOB ADDRESS <br /> <br />c:t rfs <br /> <br />PARCEL 1. D. f <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED: _New Construction _Addition ~teration _Repair _Install <br /> _Sign _Move _Deaolish <br />PROPOSED USE: _Single Faaily _M/F _' of Units _M/H <br /> Leo..ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: ..r~l-a-r d'< /JiAI/J -C","r tJr nt d,~1 0 ~~- <br /> <br />BUILDING SIZE: fa" 'I -x...l/f2:, 1.l{fl~ - Square Feet. Height (JII'-C- ~.fDnr - <br /> <br />RESIDENTIAL: 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 />PERMITS REOUESTED <br /> <br />LBUILDING <br />~ELEC'l'RICAL <br /> <br />$ 737~..EE- <br />_ ~ Valuation of Total Construction <br />I 2. 5 AMP Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHAliICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUHBING GAS ROOFING <br />TYPE OF CONSTRUCTION: _Block LFraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FDllSHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />BUILDER <br /> <br /> <br />YES NO <br /> <br />*************************** <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY fJre.c,-sc.... Ccv..~/r~/ ---, J:~ <br />State Cert. or Regist. f c.h- - CA-~~ ~~,j <br />City . ense Registration f 1~"3 <br />********************** <br /> <br />CO ANY Cl-l r" ~ Cuv...rfJrt:.;-.- <br />ate Cert. or Regist.' E :;;;,.., 21 <br />City License Registration' J l.f?r <br />************************* <br /> <br />Si <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration f <br /> <br />APPLICATION APPROVED BY 1ft;f}iit;:;;;;;;;~.~.......... PERKlT OmeBa. <br />