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<br />APPLICAnON FOR PERMIT <br />CITY OF ZEPHYlUIILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER'S IWIB -~ ]:JV\. 0 ~ N 'l12."~ <br />OWER'S ADDRESSJO'\-# 5~ <br />JOB ADDRESS $, I e p f1 ~ to <br />LEGAL DESCRIP'rION: LOT(S) BLOCK <br /> <br />PHONE <br /> <br />"'v · Il.. J..... 1'""t'- <br />~ ~ +1-- <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. ,....----.. (OBTAIN PROM PROPERTY TAX. NOTICE) <br />WORK PROPOSED: ~W Construction ----./lddition ---..A1teration ~epair _Install <br /> <br />PROPOSED USE: <br /> <br />2 <br /> <br />_Single Faaily <br /> <br />-.JIove <br /> <br />->>eaolish <br /> <br />--.Jt/F <br /> <br />_' of Units <br /> <br />--.Jt/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />~estaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: .5 e 're€.-Y\ ~fY\ W4lLj <br /> <br />BUILDING SIZE: ~ 0 X 3, /6 D Square Feet, 7 6 f ~eight <br /> <br />RESIDERTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~~DG <br /> <br />$-1 ~ 75 dJJ-- <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---llECBAIIICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />.-PLUfIBDiG GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF mNSTRUCTION: ~1oclt _Fraae _Steel <br /> <br />Other <br /> <br />FDIISBBD FLOOR ELEVAnONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br /> <br />~ COIIPMY ~nrrJ~ ltiOvl{V10M <br /> <br />. , State Cert. or Regist.' <!-~i~~'77 <br />. City License Registration . <br />.............. ........................... <br /> <br />BIIYI.DER <br /> <br />RT.R.C"I'RTCIAN <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />SilmAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />IlECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />nTRR.R <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLICAnON APPROVED BY <br /> <br />PERMIT OFFICER. <br />