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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'SNAME <br /> <br />M~ "J~~ ~f\.Q'>>..A-~ <br />~\S~ ~~ S~ <br />O~~~ <br /> <br />PHONE 78"2- 6c~S <br />l L~~t\~t.\-\ IWl. <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROH PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ~teration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_H/F <br /> <br />_, of Units _H/H <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant Ii Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ 3, <..c rC:> ..~ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CHANICAL <br /> <br />$ <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />Valuation of Mechanical Installation <br />~ ROOFING SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDITSBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />F <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />RITU.nER <br /> <br /> <br />COHPAIIY <br />State Cert. or Regist. f <br />City License Registrat' n . <br />************************************* *** <br /> <br /> <br />/' <br /> <br />Signature <br /> <br />=AR <br /> <br />/ <br />/ <br /> <br />COMPANY <br />State Cert. or Regist. <br />City License Regist ion' <br />********************************** ****** <br /> <br /> <br />PLUMBER <br /> <br /> <br />COHPAIIY <br />State Cert. or Regi <br />City License Regi ration # <br />********************************* ******** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />COMPAIIY <br />State Cert. or Reg <br />City License Re tration' <br />****************************** ********** <br /> <br />~~ <br />Signature . - <br /> <br />~ COHPANY ~Mu... ~""'--,,,.~ <br />..... State Cert. or' aeglst..' ~-e..~Slq l<-s..3 <br />. City License Registration I 2Rc... <br />. ~...***************************.*****.** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />