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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />tllFfL -1j5~~6' <br />1- /1-'1 <br />~ <br /> <br />OI/IIER' S _lfu.. f rf\.AA. ~YYUJ::> W~ PHONE <br />OWNER'S ADDRESS ~~9IS '5~ ~ ~ Z~~l.~ <br />SA~~ <br /> <br />18 ~-lo(g;;;). 7 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D..-1I- 2L,- 2...\ - OOlo - l+scCC - O\OQ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction ~Addition _Alteration _Repair _Install <br /> _Sign _Kove _Deaolish <br />PROPOSED USE: ~Single Faaily _KIF _' of Units _K/H <br /> . <br /> _eo..ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: dL\ 1< ~ '3 Add~:t.w; ~ fo.ui- . haAd; ('~ hA-iJ... /Wh~Ppor/ CiYI CJtJ.-, <br />BUILDING SIZE: a L\ x 33, Square Feet, Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />XBUILDING <br />~ELEGTRlCAL <br /> <br />$ <br /> <br />h\'1 ,q \5 .Oll <br /> <br />Valuation of Total Construction <br />X Florida Power Corp. <br />. <br /> <br />W.R.E.C. <br /> <br />8IS"TItU::,.- AMP Service <br /> <br />~CIIANlCAL <br /> <br />~PLUKB~NG <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block. _Fraae _Steel <br /> <br />Other <br /> <br />FIBISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BIJTI.DER <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY ~~A()a CQK~\\~ . <br />State Cert. or Regist.' R~ 00 '32,..'::) 24- <br />City License Registration . 2.f>.3 <br />. ................................. <br /> <br />COHPANY ---=Rf)~ ~~ .. <br />State Cert. or'ltegist.. 'Oolll~ ., <br />City License Registration' ~~~ <br />............*.........*............*..*... ' <br /> <br /> <br />Signature <br /> <br />PLUMBER. COKPANY --r-f\ 0 _ <br />~ ~ ~ State Cert. or Regist. . <br />Signature {(.4 City License Registration <br />.l........................................ <br /> <br /> <br />KECHANlCAL <br />Signature V <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration , <br />.......................................... <br /> <br /> <br />OTRRR <br /> <br />COKPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT ~ICER.~U;rlD ) <br />g,t p-/:;.r ~ <br />~ / 1 <br />