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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE /C ~.t'C'fI d f ~ <br />OWNER'S ADDRESSV"it?'irt' ~J~#L}/,/! ~ <br />JOB ADDRESSl/' ~/1hJE <br /> <br />PHONE <br /> <br />?~h'y~;f?~ <br /> <br />F~ <br /> <br />LEGAL DESCRIPTION: LOT(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 />____Kove <br /> <br />____Deaolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____KIF <br /> <br />____, of Units ____K/H <br /> <br />_Co..ercial <br /> <br />_Indust. <br /> <br />_Swta. Pool ___Other <br /> <br />____Restaurant & Health Department Approval <br />DESCRIPTION OF WORK: D)~...-11-ca~~ ~ ~ fJJ.J~<" <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 & (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 />~~LDING <br />~~CAL <br /> <br />PERMITS REOUESTED <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />Al1.P Service F.lorida Power Corp. <br /> <br />W,R.E.C. <br /> <br />_l1.ECHAlUCAI. <br /> <br />$ <br /> <br />Valuation of Mechanical Insta.llation <br /> <br />____PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block ____Fraae ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br />8J11I1,1ER ~CIJlfpAIIY'/(~_1J1;.~/.I t'F <br />~ I f <br />/:... '"" ' " State Cert. or Regist. # <br />Signature"/ ~ '4A..A....-'. City License Registration # <br />******** **** ************************** <br /> <br />~~~~ CIlIIPANY l __J~~l,c." -:!&;t'{..(2. ~A" , <br />-.......::: ~~ ~ ~ State Cert. or Regist. , - (XI n 2- <br />SiQTlAture ~.~ f~ City License Registration * -1 ....-/-'l.... I 'l <br />. ****************************************** <br /> <br />(::;/C),D <br /> <br />PLUMBER <br /> <br />A/;? <br /> <br />COl1.PANY <br />S~te Cert. or R~gist..' FR:r~~~~ <br />C1ty License Reg1strat1on t <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL ;/ <br />Signature _)//).7 <br />. I <br /> <br />COl1.PANY <br />State Cert. or Regist. , <br />City License Registration # <br />****************************************** <br /> <br />OTRRR <br /> <br />COl1.PANY <br />State Cert. or Regist. t <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER, <br />