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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER t S NAME <br /> <br />R ~ /.114 ~ <br /> <br />170 ( U-4 L 1:'\/ <br /> <br />PHONE ~ /.1 ~ 7 J }-' - 7 ~..f" 2. <br /> <br />OWNER t S ADDRESS <br /> <br />] 0 S-o ;r-~,( 1/ IS' II <br /> <br />/~ <br /> <br />110(.... (/)4,-/ / F-L. <br />/ <br /> <br />:Y'TG 9cJ <br /> <br />JOB ADDRESS <br /> <br />66/7 <br /> <br />Fo)< M'U)/~ <br /> <br />~ tZ. Z ~ IJ H 'O?, If ILL J /~ C <br />,,/ " <br /> <br />:J:J f'YI <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />6J:' <br /> <br />BLOCK <br /> <br />SUBDIVISION S-I L 1/ l" I~ 0 A kJ <br /> <br />PARCEL LD.' 01 '2. t;;; 1. I 0 I 2. 0 000" () {) (, ,f-o (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br /> <br />WORK PROPOSED: ~ew Construction _Addition --Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_DeIIOlish <br /> <br />PROPOSED USE: ~ingle Faaily <br /> <br />_M/F <br /> <br />_, of Units _M/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant &: Health Department Approval <br /> <br />DESCRIPTION OF WORK : C.o /\J ..I' ,/2 '-r c (- ,IV X 1-/ S'/ .1\/ 6- '- t. "i--"/9 M / L. Y <br /> <br />/'V",' '-< J' L <br /> <br />BUILDING SIZE: <br /> <br />X Square Feet, . .Height '7~~t.(!~ <br /> <br />ATTACH (2) PLOT PLANS &: (2) SE'l'S OF BUILDING PLAN~-SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />PERMITS REOUESTED <br /> <br />/ BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction. <br /> <br />.JL.ELEC'TRICAL <br />1L.......MEGHANICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />N.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />.1..L:..PLUHBING GAS ROOFING <br />TYPE OF CONSTRUCTION: /' Block _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FDlISBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />t' <br />., <br />.l.c4-~ <br /> <br />~rL~ <br /> <br />COMPANY ,R C f U;tf I( I'f'o I {)t4 '- t,-... ff'-< I '- d L-< <br />State Cert. or Regist. . c te c_ 0'-10 7 yO <br />City License Registration' 17 Yy <br />.......................................... <br /> <br />./ <br /> <br />Signature <br /> <br />=~~ COMPANY )~cA~r E".xc.h,;, J~ <br />_ . ../ v / _ u - J .h State Cert. or Regist.' e-R &O"9~" '1 ..---- <br />___.....Y_e~A~ ~//)/~ City License Registration' /51__ <br />..*~...................................... <br /> <br />Signature <br /> <br />Jr~()-(~ <br /> <br />COMPANY It-fOO'D Y '-rue. i(i:..i<.. t:>ClSc'. J-N C <br />State Cert.or Regist. , <br />City License Registration . <br />.......................................... <br /> <br /> <br />v" <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANYJjDOD 'I Ie, G 1'"- f. ~ J> L Be... .r;" ( . <br />W I (/) c::::r:-= State Cert. or Regist.' Cite 03 q ~ '7 '1 <br /><C<.' - I ,~ City License Registration . / :I' y- <br />. <br />.......................................... <br /> <br />~ <br /> <br />MECHANICAL <br /> <br />/.?oorl,rf"' t-oflP-, <br />OTRRR (-<.., / , <br />V/ <br />Signature . ~ ~~ <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />................................*......... <br /> <br />APPLICATION APPROVED BY <br /> <br />r!~~ lh~d <br /> <br />PERMIT OFFICER. <br />