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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAHIl rfM/.-d ~zW~ <br />OWNER'S ADDRESS a/f3 ' iJJ/Jltlc- ~ <br />6 ~, <br /> <br />LEGAL DESCRIPTION: LOT(S) & I 7,8 BLOCK 9 SUBDIVISION <br />PARCEL I.D.' /1-:2b e2j-OO/lJ "'00900 - Do8o <br /> <br />G~ fL~~f6 <br /> <br />JOB ADDRESS <br /> <br /> <br /> <br />PHONE <br /> <br />IUW <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED: /New Construction vAddition _Alteration _Repair _Install <br /> _Sign _Kove _Deaolish <br />PROPOSED USE: _Single Fa.ily _KIF _, of Units _K/H <br /> ,,/' _Indust. _Swia. Pool _Other <br /> _eo..ercial <br /> <br />_Restaurant & Health DepartJllent Approval <br /> <br />DESCRIPTION OF WORK: A1)V177{)'(0 'lD ~~ f&L ~ breJ) s7lflle€"" <br />. . 4- ( <br />BUILDING SIZE: 13 X Ii-, 2- J Square Feet, (fj 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 />_BUILDING <br /> <br />$ <br /> <br />10/[>>) , <br /> <br />, <br /> <br />Valuation of Total Construction <br /> <br />~=:s <br /> <br />III PLUKBING <br />TYPE OF CONSTRUC'I'ION: <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />Valuation of Kechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br />.V Fra.e _Steel <br /> <br />SPECIALTY <br /> <br />_Block <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJEC'I' IN FLOOD ZONE AREA? ~ <br />YES NO <br /> <br />........***********.*..********.******.*** <br /> <br />Signature <br /> <br />~' COMPANY -:--iJJ,!ft0( <br />State Cert. or Regist. . <br />City License Registration . <br />*****************************.************ <br /> <br /> <br /> <br />BUILDER <br /> <br />RT.RCTRTCIAN <br />SianAture ~,Q.,::r <br /> <br />COMPANY ~otU"R' ~tt.61J15 <br />~ State Cert. or Regist. f <br />, City License Registration f "'f <br />.***. ********************.************** <br /> <br />Signature <br /> <br />)Ii; <br /> <br />I <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****.**.*.*******.*****.*.**************** <br /> <br />PLUKBER <br /> <br />Signature <br /> <br />/;; COMPANY <br />1/1/J State Cert. or Regist. f <br />/v,0' City License Registration' <br />I <br />.********.*~**************.*************** <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration # <br />.***.*.*..****.******.*********.******.*.* <br /> <br />OTHRR <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />