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<br />APPLICATION FOR PERK1T <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />(J~:L <br />/}1-J :;:-7!P <br /> <br />OWNER' S NAME ~ f... c.. K <br />OWNER · S ADDRESS 3 c; I 0 S' <br /> <br />;V\, ;V\ c.c.1'\ ~ TN f.- V <br />& Iii AVE 2UtfYiC-HIU-S <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />5AVV\t::.. <br /> <br />LEGAL DESCRIPTION: LOT(S) 00':< A <br /> <br />BLOGKODJoo SUBDIVISION {)O2. V <br /> <br />PARCEL I. D.' I::J... -;< tfl- .:l. I 00 ~ 1'\ - 0030 0 - 00 2. 0 (OBTAIN FROK PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction K Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: ~single Faaily <br /> <br />_KIF _, of Units _K/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: PAM lLY ~OM AbDIT10N <br />BUILDING SIZE: J 6? X .30. t{ 80 Square Feet. 8' Height <br />. <br /> <br />.. <br />;~'. <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 />~BUILDING <br /> <br />J2(ELEGTRlCAL <br /> <br />~GIIANlCAL <br /> <br />PERMITS REOUESTED <br />$ I ~ J 3 SV' 12 Valuation of Total Construction <br />, <br /> <br />~X(.5T)NG AMP Service C< Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />...<. SO <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br />TYPE OF CONSTRUCTION: ..KBlock _Fraae _Steel <br /> <br />SPECIALTY <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 />BIITI.DER <br /> <br />A/ ~ OIJKPAIIY cN,I1.E:. - F<R-I<- <br />~ Slat Cert or Regist. . c..G C. C) <br />/ ~~ City License Registration . <br />, <br />.......................................... <br /> <br /> <br />Signature <br /> <br />~::..-&~~ COHPAIIY fNVI~ON/VIE'-NTJ4L CoNfR.""'TOJ:.5 <br />State Cert. or Regist. . I3-R 0013S83 <br />City License Registration . '-;1. '5 g' <br />.......................................... <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />I(/( <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration t <br />.......................................... <br /> <br />COMPANY EN Y/J"<-ON mEAl TA L CONTR..JI\C-TOR-5 <br />State Cert. or Regist. I C. tqc 0.2. q 3 c9..?. <br />Signatur City License Registration' J 0 2> <br />..~.............................. <br /> <br /> <br />OTRF.R COMPANY <br />State Cert. or Regist. I <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERK1T OFFICER. <br />