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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILlS <br />BUILDING DEPARTMENT <br /> <br />y!<r ~~F~ <br /> <br />OWNER'S ADDRESS <br /> <br />(2o ~S <br />C::, 5"'1 1- <br /> <br />fk/k~/' <br /> <br />JOB ADDRESS <br /> <br />Broe....h-..uc <br />fJ{~~~ OrlVw <br /> <br />PHONE 7 ~ '- - 'I)7~ <br />Ol"~ Z..t,LilLllU, /1" :J 15''1/ <br />2"'7(71(, i -/1.) / jJ!~y.i(. J 1 S-'1 I <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: I.OT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />X MIF Z-. of Units _M/H <br /> <br />_~ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br />BUILDING SIZE: to 1 <br /> <br />r .e~.l <br />X 7 b , l--'zloo Square Feet, <br /> <br />o ( J' kl-e t.., t...- <br />b Height <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 />V aD () t> - ~L\./).., <br />~BUILDING $ I I v Valuation of Total Construction <br />V ""70i> {/ <br />~ELEC'J'RICAL v AMP Service ~Florida Power Corp. <br />(/ (, - ~Lc,t <br />~CHANICAL $ 2 0 j) . Valuation of Mechanical Installation <br /> <br />APLUKB~NG . GAS XROOFING SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: XBIOClt _Fraae _Steel Other <br /> <br />FINISHED FLOOR ELEVATIONS: 11 Fl'. IS PROJECT IN FLOOD ZONE AREA? <br /> <br />W.R.E.C. <br /> <br />YES <br /> <br />X <br />NO <br /> <br />............****..*..**.**...*****..*..*** <br /> <br />BUILDER <br /> <br />/~ <br /> <br />"" <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY ;J. 'II .~~. I!-/r~j.....s I~<'. <br />State Cert. or Regist.' CL c.. O.,b/~1 <br />City License Registration' z,..Y9 <br />**.*************************..************ <br /> <br />v <br /> <br />Signature <br /> <br />ELECTRICIAN COMPANY IE"~,- ,rl.eJv. L- <br />:=~::~ ~ ~ State Cert. or Regist. f f/lo,'01.-71)" <br />)( ~ City License Registration f <br />******.*******.*******.***.**..*********** <br /> <br /> <br />PLUMBER <br />Signature /::;;647-(. <br /> <br /> <br />COMPANY /J~~".,-tj ,Pf.-.)._, <br />State Cert. 0 Regist. f CPc <br />City License Registration f <br />***.****** ******************************* <br /> <br />4 ,/2- 'f~ S~ <br />Jfr .;)..1 <br /> <br />v <br /> <br />MECHANICAL <br />Signature >L <br /> <br />~ COIlPAIIY'" ' ;;J.>..v~J. <br />State Cert. or Regist. f 00 <br />City License Registration . <br />*.. .*..******.********.*.*************** <br /> <br /> <br />/ <br /> <br />OTRF.R <br /> <br /> <br />COMPANY n - I tt.....f;~ <br />State Cert. or Regist. t /<tc <br />City License Registration t <br />****.*******************.***.************* <br /> <br />O()b l'Izr- <br />Be <br /> <br />Signature <br /> <br />( . <br />APPLICATION APPROVED BY <br /> <br />PERKlT OFFICER. <br />