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<br />, <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBlLLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAME <br /> <br />...~8~,or ~ <br /> <br />1?;~Q <br /> <br />PHONE <br /> <br />?B02-t/;l7,?1.. <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />'6 D6 <br /> <br />6/4l1 i? (ueV ' <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL LD.' 02- ;;.. G. til-I- 00 t' 0 - O~& OO.t!)a;zo (OBTAIN FROK 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 /> _ec:-ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: S 76,J ;p/ c- <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 FORKS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <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 /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MEGIIAIflCAL <br /> <br />$ 1(~ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDiISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA T <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />.......................................... <br /> <br />RUn.DER <br /> <br />Signature <br /> <br />~~~,/ - . COMPANYA~ct:4/i?O CKff..u:l4L( ELecTk,..c.:;..L CCM)T, <br />. / 0 /' State Cert. or Regist. t <br />onAtur / .t'-r"~K (.A!-d>~..&-d City License Registration t () 7"z <br />......................................**.. <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration f <br />.....................*..........*...*.***. <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br />C a.vih-../ <br />State Cer . or Re ist. t <:90 S- <br />City License Registration , <br />...............................*.....**.* <br /> <br />COMPANY <br /> <br /> <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />~~~......................... <br /> <br />OTRF.R <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />