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<br />APPLICATION FOR PERMIT <br />CI TY OF ZEPHYRlIlLLS <br />BUILlHNG UEPARTtlENT <br /> <br />f~f1ir1~ <br />or9~7~ <br /> <br />-I. t!..AV /N t!'t~ f <br />OWNER'S AUURESS < --3 ?? J- 6/ ILJ -14 It-1/e Z ~th r 1/ ~ /! /.11 R Jd>OY / <br />JOB ADDRESS \-)7/\.5":1' ~ 71, 0j-J-e~r 2~~h yYh "(0 ~ ,c7. \y~/ <br />LEGAL UESCRIPTION: LOT(S) / --1{- BLOCKt7e?~SUnDIVISION <br />PARCEL I.D.# / / 4" ;J../ p~/L' <br /> <br />(;AVYle. <br /> <br />PHONE <br /> <br />OWNER'S NArtE <br /> <br />o tJ / /JZ' tJ6)80BTAIN FROM PROPERTY TAX NOTICE) <br />, , <br /> <br />WORK PROPOSED:~New constructi~u <br />_Sign <br /> <br />_Addition -^lLeration <br /> <br />_Repair _Install <br /> <br />_Move <br /> <br />_Demolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />-"IF <br /> <br />_# of Units _M/H <br /> <br />_Connercial <br /> <br />_Indust. <br /> <br />_Swim. Pool _Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />t%ff;-~/,~ +(~/Pr~/~ <br /> <br />BUILDING SIZE: ~x :JJ-, ....:;~ " Square Feet, y I Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORM~. <br />COHMERCIAL: ATTAL11 (3) SETS . OF. BUILDING PLANS & (1) SET ENERGY FORMS. . <br />\ , <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />/tfIX~ <br /> <br />. <br /> <br />DESCRIPTION OF WORK: <br /> <br />PERMITS REOUESTED <br /> <br />~UILDING <br /> <br />/ ~~ <br />$ ~/ t; t:? p . ...:-- <br /> <br />Valuation of Total Construction <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_ELEL"'TRICAL <br /> <br />AMP Service <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />BUILDER <br /> <br />CONTRACTOR SECTION <br /> <br />L CllIIPAIlY C""*" /' 1//- <br />. ~ State Cert. 0 Regist. <br />/6'. //4 ~ City License Reg ration # <br />********* ******************************** <br /> <br /> <br />YES NO <br /> <br />1qJ.~i31/Y <br />11/ V--' <br /> <br />'\ <br /> <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAN <br />Si2nature j!{;) ~uJ <br /> <br />COMPANY F~e' Ekr7KrL <br />~ ~ State CerL or Regist. # r' ~. <br />City License Registration t <br />****************************************** <br /> <br />1/--- <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. i <br />Signature City License Registration * <br />.*.*...*...*.****....**.*.****.***.******* <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration , <br />..***********.**....******..*****.******.* <br /> <br />OTHER COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration t <br />**.****.*....*.******.....*...*.**.......* <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />