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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />/Jtp-U f ~ 7~ <br /> <br />:~ A r 9'0 -:. <kJ <br />g;-'3'z; -~ <br />, <br /> <br />OWNER'S NAME <br /> <br />feDei?,4L Affo.eIJ/J78~ rk:uS~NC; <br />- <br /> <br />PHONECBI3J 1./4fc - 7'81 <br />ill!> 1(, C)U LF '10 B4( 1?Lun CLt?A-~~~ R--. <br />2 ep~ t2 ;.n Las R-. <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS / ; - 2(., -21/7 111 ae;e W~ <br />LEGAL DESCRIPTION: LOT(S) "2 "2 <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:-y'New Construction _Addition -..Alteration -Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: ~Single Faaily <br /> <br />~/F <br /> <br />_, of Units ~/H <br /> <br />_<=<-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: w,..J$~T 4Jf:h) l1A.Jeu;-NJ <br />BUILDING SIZE: SO' xS-;- . !bo:; Square Feet. I~ Height <br /> <br />RESIDENTIAL : <br />COMMERCIAL <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~BUlLDING <br /> <br />LELEC'flUCAL <br /> <br />-X-MECHANlCAL <br />LPL~~NG <br /> <br />$ <br /> <br />t/~ DJ/ .'?E- <br />. <br /> <br />Valuation of Total Construction <br /> <br />r <br />I":> D AMP Service Florida Power Corp. <br />, <br /> <br />2? ,/ 00 <br />::>;>0 Valuation of Mechanical Installation <br />" <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: -L,Block _Fr8JIe _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? ~ <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />BIJTI.DER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />Iq.RC'flUCIAN <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration , <br />.......................................... <br /> <br />SifmAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.*.*.**.*****.*****************..***..**.. <br /> <br />Signature <br /> <br />.. <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />...............*................*.*****.** <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />...............*.*............*.....*..... <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />