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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYImILLS <br />BUILDING DEPARTMENT <br /> <br />, d -7~0 <br />~ -:? -{).&s <br /> <br />OWNER'S. NANE ;<~h ~ mONE <br />OWNER's ADDIlIlSS - - - _ ~ ~_ r ~j?/t <br />JOB ADDRESS 3'7 J {", f!;~' /~I <br />LEGAL DESCRIPTION: LOT(S) c:::; ~ BWCK SUBDIVISION <br />PARCEL I.D.' ~ ~ 2(" - 2/ <br /> <br />Pf/ .7S~ 6 <br /> <br />SL~ [)~ <br /> <br />bl~O <br /> <br />.-@- D <5:'1 cJ (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_DeJIOlish <br /> <br />PROPOSED USE: _Single FOIily <br /> <br />_H/F <br /> <br />_' of Units _M/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />----Restaurant & Health Depar..en~~roval <br />DESCRIPTION OF WORK: S~ ~ <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 REQQlRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />(,q'1 ,g;-o <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHAlUCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _FrOle _Steel <br /> <br />Other <br /> <br />FlIUSBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />..................................******** <br /> <br />YES NO <br /> <br />BUILDER <br /> <br /> <br />CONTRACTOR SECTION _ <br /> <br />./l/r~ tI - 7d: ;(/tJt! /111 t/U <br /> <br />State Cert. or Regist. , <br />City License Registration , <br />*.**...*.****...*******..*....*********** <br /> <br />COMPANY <br /> <br />Signature <br /> <br />/410 "':?, <br /> <br />F.T .RCTRIClAN <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />**..**..*.*.****...**....*..*..******.***. <br /> <br />SignAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />**..*.*...******................*...****** <br /> <br />Signature <br /> <br />MECHANICAL <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. I <br />City License Registration I <br />.***.....*.*.*******.**.******.*********** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />