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<br />APl'LlCATION FOR PERKrT' . <br />CITY OF ZEPHYRHlLLS <br />BUILDING DEPAR1KENT <br /> <br />~t~ <br />~H <br />1,t -?3 0-6 <br /> <br />~I''- <br /> <br />OWNER'S _ ~ ~ ~ <br />OWNER'S ADDRESS /Cj 6fJ/"i .f5 {}/AC ~ A"' D (Jl/.../ rJ<; <br />JOB ADDRES~ =- g ~) :J8":J--P ~?t3?If3culleN5 IRA/I.- <br />LEGAL DESCRIPTION: LOT(S) 5"Q BLOCK SUBDIVISION Sit ve~' OAKS <br />PARCEL I.D.t 3L~-;)I- 0/60 - 00000 - O~ (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~NeW Construction _Addition ~teration _Repair _Install <br /> <br />PHONE <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED~E:)( Single Faai4 <br /> <br />----KIF _, of Units _M/H <br /> <br />_ec-ercial <br /> <br />_lndust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: $o)JLe P,&)/Y)/Ly ;fps <br />BUILDING SIZE: X Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMl1.ERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />_BUILDING <br /> <br />PERl1.ITS REOUESTED <br />$ '>q 000 Valuation of Total Construction <br />I~O AMP Service Florida Power Corp. <br /> <br />LW.R.E.C. <br /> <br />_ELECTRICAL <br />.-<'MECHAlUCAL <br /> <br />$ :SO~cJ <br /> <br />Valuation of Mechanical Installation <br /> <br />o <br />_PLUMBING GAS :S~I~jL~ROOFING <br />TYPE OF CONSTRUCTION: ..k.Block _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FDUSHED FLOOR ELEVATIONS: <br /> <br />F1' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />....*.......*...............**......*.**.* <br /> <br />CONTRACTOR SECTION <br /> <br />BllJIllD. COHPAIIY R~ '1,,~ &JJ.J.4, <br />..A ,1 U f)~ State Cert. r Regis t C'c.C.O st;;;l.f?r.Y <br />Signature ~A7 CA ~X / City License Registration t /?? <br />**** .***. *. *'**~~~~*'*****:***.*~~***.*~~*~*..' . '. . .' ,,- <br />, . . /"/./ / . I ( ) ..... Ilk ..'./,rf"-":-> ,? <br />RT.RCTRICIAN , . -tOl1.PANY 5+-$' ELe'cJrt!.ic' -- <br />C\ <7 State Cert. or Regist. t EJ(' c;S/S'9 <br />Sianature ..J::;YrJ.A..J'€., ~~ City License Registration' 3a::J <br />***..**..**.*..**********.*..*.**********. <br /> <br />v <br /> <br />/ <br /> <br />PLUl1.BER COl1.PANY~.-.--.. -f ~ <br />/J/J I -;,1 _ J State Cert. or Regist. t ~;:. C/~hS <br />Signature ~AAJ.IY ~ _ ~r.k...-- City License Registration' Js'/ <br />**.***.*.*.*****************.************* <br /> <br />tI' <br /> <br />.. <br /> <br />MECHANICAL <br />Signature ~ ~ <br /> <br />COl1.PANY ,c;~;(~ lJ A/~ ~..tJ <br />State Cert. or Regist. , <:: cos;;Z <<~? <br />City License Registration , ~~ <br />.**.*.**..********...***.**..**.*********. <br /> <br />/ <br /> <br />OTIIRR <br /> <br />COl1.PANY <br />State Cert. or Regist. t <br />City License Registration I <br />.*.***.*****.********.*.***..**.********** <br /> <br />Signature <br /> <br />APPLICAnON APPIlOVED BY '-f/ ~ ~ J11 ~~ <br /> <br />PERl1.IT OFFICER. <br />