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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE <br /> <br />DEN,..,; ~ <br />"3'7~(1 <br /> <br />S~f4 <br /> <br />I <..( 'f-to\ <br /> <br />AN <br /> <br />PHONE 81 '3 ???:J... S ~ '74 <br />2~((\('" <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration -Repair _Install <br /> <br />_Sign <br /> <br />----..JIove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_M/F <br /> <br />_, of Units _M/H <br /> <br />_ec:-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant &: Health 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 &: (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />_MEGHAIIiCAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <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 _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />GOHPANY <br />Q 'I ~ State Cert. or Regist. . <br />~ - - ~ ~ City License Registration' <br />L: ~~************************************** <br /> <br />Signature <br /> <br />F.T .RGTRlCIAN <br />SisrnAture D1/..4t. ; <br /> <br />COMPANY <br />~ State Cert. or Regist. . <br />~ ~ City License Registration , <br />*~******************************** <br /> <br />PLUMBER <br /> <br />GOKPANY <br />State Cert. or Regist. , <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration , <br />***********~****************************** <br /> <br />Signature <br /> <br />OTRF.R <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />