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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />c) .. <br />, <br />PHONElt)~ - ~~ <br /> <br />OWNER'S NAME ~~f.,.S:> ~N}.... <br />OWNER'S ADDRESS '5l d.::\ ~\'L~~~f\. <br />:SO~ <br /> <br />"5\,' <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL LD.' (i). U,..- z..., - oa~t::l ~ C>~ I \)(j - Cf~b ~ (OBTAIN FROH PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction ~Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_DeJlolish <br /> <br />PROPOSED USE: )(: Single Faaily <br /> <br />_H/F <br /> <br />_, of Units _H/H <br /> <br />_C~ercial <br /> <br />_Indust. <br /> <br />_Swim. Pool ___Other <br /> <br />_Restaurant & Health Department Approval <br />DESCRIPTION OF WORK: ~\\.....D ~ ~)4"") <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 />_BUILDING <br /> <br />$ <br /> <br />I? ~l ~ <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AtIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />.--JfEGllANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUKBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fralle _Steel <br /> <br />Other <br /> <br />FIRISUED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECI' IN FLOOD ZONE AREA? <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />yONTRACI'OR SECTION <br /> <br />BUILDER ~~~~ COMPANY 5:uA) 5"~re: <br />6~";'~:::~~7~ .-' - // State Cert. or Regist.' . <br />Signature-L--,,-- ", City License Registration , <br />~---_.- .,...- .--'- .......................................... <br /> <br />/fLvlf/v'i.,iJ(. <br />7V <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration , <br />.......................................... <br /> <br />SiQllature <br /> <br />PLUKBER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration # <br />.......................................... <br /> <br />Signature <br /> <br />KEGHANI~ <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />..........................*.*..*..*.*..*.. <br /> <br />Signature <br />" <br /> <br />!)THF.R <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration # <br />.......................................... <br /> <br />Signa ture - <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />