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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />~-I- t-t, <br /> <br />OWNER'S NAKE ~ m c. A <br />OWNER'S ADDRESS .37 -z.. \ C1 -Pc..:;C.O <br />JOB ADDRESS -37 LIe; <br /> <br />~mL!l <br /> <br />PHONE <br />JltloJo (' De <br />/1('(' I r:cv? J(">'3 Y <br /> <br />R~_ <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. t <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition -^iteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single 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 Ii 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 Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORKS. <br />ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS 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 />---1IECllANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PL~ING GAS ROOFING <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FDJISHED 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 />BUn.DER <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />RT.RCTRICIIAH <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />****************************************** <br /> <br />SianAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />.. <br /> <br />Signatu <br /> <br /> <br />(j. /- <br />COMPANY e ~U {I l c: <br />State Cert. or Reg~st. f <br />City License Registration f <br />****************************************** <br /> <br /> <br />v--- <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration t <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />