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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />JOB ADDRESS <br /> <br />j}/ark <br />, <br /> <br />6,jD~ tf9I:;:-I! <br />~~- - 0' () <j c""::j<l- // <br /> <br />?i;.' --- ~ <br />~ <br /> <br />1/ /) <br />t-. c{ <br /> <br />OWNER'S NAME <br /> <br />fJ {} I-J <br /> <br />PHONE 76.;: ~ l6~' ~- '/ <br /> <br />OWNER'S ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL L D.' <br /> <br />/ (- ;)~ & - /) J - (0) C - 2. 0 B CJO -, 0 06 0 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration ---.-:Repair _Install <br /> <br />_Sign <br /> <br />--1fove <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 />C-- / r"l ' ~ <br />) .......- ""-" <br /> <br />.I! /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 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 />_ELEC'flUCAL <br />~ttECllARlCAL <br /> <br />AMP Service Florida Power Corp. <br />S 3 c.; 5 c~_ q;;~",;"t Valuation of Mechanical Installation <br /> <br />W.R.E.C. <br /> <br />~UMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIRISBED 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 />Signature <br /> <br /> <br />COMPANY <br />State Cert. or Regist.' - ~(~ <br />City License Registration , <br />*.*.*******************.************ <br /> <br />RUTT.DER <br /> <br />COMPANY ~AJ NN <br />State Cert. or Regist. . <br />City License Registration , <br />*..********.**.*********.***.***.********* <br /> <br /> <br />Signature- <br /> <br />------- I L ) <br /> <br />//( <br /> <br />COMPANY /~7" /oJ S -<;,. (""0, vi". <? <br />State Cert. or Re&ist.' 1PC)~2 <br />City License Registration' .' / P-:;J" <br />.**************.*.*****.*..***.*********** <br /> <br />PLUMBER <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />..****.*..*~*************.****.*********** <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration # <br />**.***.*******************..************** <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />