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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />_'S IWIE _J1J~ J!)d~L <br />OWRR'S ADDRESS .5 grt 0 / tI& a!-r~. <br /> <br />PHONE <br /> <br />7po ?:? ~,7 <br /> <br />JOB ADDRESS <br /> <br />. ~'-0 <br />- <br /> <br />LEGAL DESCRIPl'ION: LOT(S) <br />PARCEL I.D.t(jU /1 1 <br />, <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED :_New Construction ----Addition 1..AIteration --Repair _Install <br /> <br />_Sign <br /> <br />---..Hove <br /> <br />_Deaolish <br /> <br />~OPOSED~E: _S~eF_i~ <br /> <br />---..HI F <br /> <br />_' of Units ---..H/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant &: Hea1th 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 &: (2) SETS OF BUILDING PLANS &: (l) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS &: (l) SET ENERGY FORMS. <br />~OPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />-----BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'l"RICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-'lECBARICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Insta1lation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: _B1oclt _Fr_e _Steel <br /> <br />Other <br /> <br />FD1ISBED FlOOR ELEVAnONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZORE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BUTT.DER <br /> <br />Sipa~O <br /> <br />~ ~ ampARY <br />State Cert. or Regist. f <br />) ..A. City License Registration f <br />**** ************************************* <br /> <br />RT.RCTRICIAR <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />****************************************** <br /> <br />Sf IDTUllture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />IIECllARICAL <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />