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<br />(Or2F pJ2~~ . . <br />)/jV <br />" 'l-9S- <br />/l"~ <br />PHONE 79'S - 7'fJ l- <br />0IlRER' S ADDllESS 37 21 <0 &..!M:: '1 ~J. J;l.:.k c.ry I ,e./.... 35 ~ 2S' <br />JOB ADDRESS 57 / n ~;J.,.f'~ ':);b.z- 2-e,..I...A III, /t.. ns-rl <br />fi . -r . . <br />LEGAL DESCRIPTION: LOT~ 5:'/ B~~ :::r'SUBDIVISION t/lrl#~ Lid.J <br />PARCEL I.D.' 03 - Zb - Z/ - () 12 ~ - 000 va - O~BTAIN FROH PROPERTY TAX NOTICE) <br />WORK PROPOSED:~ew Construction _Addition --...Alteration _Repair _Install <br /> <br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME <br /> <br />EJb~ <br /> <br />B~cetUl~ <br /> <br />_Sign <br /> <br />---1Iove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: ~ingle Faaily <br />_~ercial <br /> <br />---1I/F _' of Units _H/H <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant Ii Health Departaent Approval <br /> <br />5.1-j/- P~./1 t;}j.,- M.~ . <br />1>' ~' [l' (7' fl~ <br />BUILDING SIZE: 1. X . 1'1'11- Square Feet. 0 Het8ht <br /> <br />~ID~~A'lTACB (2) .:..o.r PlANS . (2,t;;ETS OF BUILDIRG PLAIIIS . (l)~ET EIIEIlGY FORKS. <br />tHannv : ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. ~.O. /Jfu,. ~ <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />DESCRIPTION OF WORK: <br /> <br />~BUILDING <br />~CTRICAL <br />-XMECBAlfICAL <br />~UHB~NG . <br /> <br />~ /' PERKITS REOUESTED <br />$ 5X /)() &.) Valuation of Total Construction <br />Zoo AMP Service X Florida Power Corp. <br />$:( 1.200-- <br /> <br />W.R.E.C. <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />TYPE OF CONSTRUCTION: XBIOCk _Fraae _Steel <br />, <br />FIRISBED FLOOR ELEVATIONS: Y:J FT . <br /> <br />..>( ROOFING <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />YES <br /> <br />X <br />NO <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />~ COIIPARY-B:1 I (1..... ("..IrJ.~'1. .... <br /> <br />~ State Cert. or Regist.' CfL l>S;-&-' &J I <br />Signature City License Registration . Z. ~~ <br />~ .......................................... <br /> <br />BUIlllER <br /> <br />:::~ a?~.~ <br /> <br />~I... tl'~f~ <br /> <br />State Cert. or Regist. # tt 0002.1 <br />City License Registration # ~ <br />.......................................... <br /> <br />~~ <br /> <br />COMPANY <br /> <br /> <br />PLUMBER COMPANY I ~t ~""'r ~ <br />~n t~' \. '~. State Cert. or Regist.' c...F-C 0 2 <br />Signature .t--i..o.. ~~ City License Registration # ., <br />........... .............................. <br /> <br />MECHANICAL ~ COMPANY 50 ""1'\..'1') tJ, jc...6"'~',J A-~~/'4'~- <br />~ ~ State Cert. or Regist. # <br />Signature J( "'- ~~ ~ City License Registration . :1-(9 (L:) <br />...... ................................ <br /> <br /> <br />() <br /> <br />~ <br /> <br />Signatur <br /> <br /> <br />COMPANY h - J /I.~ In.:.. ~ <br />State Cert. or Regist.' lLc- oole>/'Il-r <br />City License Registration f ~ ~ <br />.................................... <br /> <br />OTRRR <br /> <br />PERKIT OFFICER. <br />