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<br />APPLICAnON FOR PElUIIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />cr/7 L L <br /> <br />M'~J J <br />~. ~d <br />C/vd. <br /> <br />PHONE <br /> <br />~/3 ,- 78y,. -:3Sol <br />?%3 =- 'JO-!J-6 <br /> <br />OWNER'S twm-j;) h.AJ"o/ ~~~- <br />OWNER'S ADDUSS ,:1 75'; I <br />JOB ADDRESS 5:S L/ '7 <br /> <br />_ '7 <br /> <br />JO/gN>~ <br />)<:;"5'5/ <br /> <br />LEGAL DESCR.IPTION: LOT(S) <br />PARCEL I.D.' /1 - Olio -(),/ - cJ LJ /0 <br />, <br /> <br />BLOCK....---SUBDIVISION <br />j'J..:LtJlJ .... Ot'7tJ (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PRoPOSED:~ew Construction -X...,Addition ~teration .-K..Repair _Install <br /> _Sign --Hove _Deaolish <br />PROPOSED USE: _SiDgle Feaily ~/F _' of Units _K/H <br /> 1~rcial _Indust. _Swia. Pool _Other <br /> <br />-.J.estaurant Ii: Health Departaent Approval <br /> <br />DESCRIPTIOR OF WORK: <br /> <br />BUlLDIRG SUE: ._"0 X .5"0. 25'00 Square Feet. ) 2. Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLARS Ii: (2) SETS OF BUlLDIRG PLANS Ii: (1) SET ENERGY FORMS. <br />COMKERCIAL: ATtACH (3) SETS OF BUlLDIRG PLANS Ii: (1) SET ERERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTION. <br /> <br />PElUIITS REQUESTED <br /> <br />/j' <br /> <br />J'rLDIRG <br /> <br />~ELECTRICAL <br />.' ,/ <br />~CllARlCAL <br />j- <br />_PLUMBIRG <br /> <br />$ <br /> <br />2.. '..2. t'e c <br />/ <br /> <br />.!..J.- <br /> <br />Valuation of Total Construction <br /> <br />200 <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />, .. <br /> <br />$ <br /> <br />4/:>('1 ~ .,- <br /> <br />Valuation of tlechanical Installation <br /> <br />GAS <br />LBloclt <br /> <br />ROOFlRG <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUCTIOR: <br /> <br />_Fraae _Steel <br /> <br />Other <br /> <br />FIllISBED FLOOR ELEVAnORS: <br /> <br />Fr. <br /> <br />IS PROJECT IR FLOOD ZORE AREA? <br /> <br />A <br />YES NO <br /> <br />..................................*....... <br /> <br />CORTRACTOR SECTION <br /> <br />BIJTI.DRR ~~&/ COMPARY {J W/Jc::R <br />, State Cert. or Regist. . <br />Signature . ~ ~. .. City License Registration . <br />.......................................... <br /> <br />(. 1 COMPANY /t1 tJ f( '1e A/ <br />~fu~/ State Cert. or Regist. . <br />City License Registration . <br />.......................................*** <br /> <br />Signature <br /> <br />COMPANY Iv\. <br />State Cert. or Regist. . <br />City License Registration . <br />. .........*...**.****....**...*.******... <br /> <br />~ J COMPANY 50/t/A/</"rs <br />. State Cert. or Regist. . <br />..J ~e?' City License Registration' <br />. ...... ...*........................**.* <br /> <br /> <br />PLUMBER <br /> <br /> <br />RI.RCTRICIAR <br /> <br />'jv <br /> <br />Signature I <br /> <br /> <br />~ COMPANY_ Ob~E~ <br />State Cert. or Regist. . <br />Signature City License Registration . <br />...........*...*.......................... <br /> <br />APPLICATIOR APPROVED BY PEBKIT OFFICER. <br />