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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />. '- <br /> <br />OWNER'S ADDRESS <br /> <br /> <br />G/LA.-N J (/.0 ~(~OA.JS <br />(;). (j . ~<<- :J..:t'f~- ~A-tlfl C, ry <br />G /Z.1$Ii'u.r tZ. I J(Z. . <br />S(p <br /> <br />PHONF..~S-d.-S.13- 17/( <br />3 3 ~- 2.-.' <br /> <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />WORK PROPOSED:_New Construction _Addition -.-Alteration _Repair _Install <br /> _Sign ---Jtove _Deaolish <br />PROPOSED USE: _Single Faaily _KIF _' of Units ~/H <br /> _<=<-ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF 1lORK. ,. -s:FT UO #1/ fI ({ ::J6 oj <br />/3' )C .JRI4" ~ / <br />BUILDING SIZE: ~ 8. _tit ._~~~Lsquare Feet. Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />_BUILDING <br />$.-ELECTRICAL <br />pClWlICAL <br />:f-PL~~NG <br />TYPE OF CONSTRUCTION: <br /> <br />Valuation of Total Construction <br /> <br /> <br />AIIP Service ---p-FIOrida Power Corp. <br /> <br /> <br />Valuation of lIechanical Installation <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />_Block <br /> <br />_Fraae _Steel <br /> <br />Other <br /> <br />YES <br /> <br />* <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />PT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />IImlBllR COIIPAIIY tl..~ M. H s <br />~ State Cert. or R ist.' <br />v"Signature ~A..... ,. City License Registration' 0/</ <br />... ..................................... <br /> <br />RT.RCTRICIAN COMPANY Ilc ~ /1 e-l2" '9 .e;..~-r-r({~f<),;:7'~ c. <br />,1:. h' I /1/7 State Cert. or Regist. " t..~s eooo 00 6,. <br />SionAture C_/~ /J~t:7U'1... City License Registration' / .:Y 7 <br />.......................................... <br /> <br />MECHANICAL <br />Signature ~ I) ~e4V1- <br /> <br />COIIPAIIY fl ~ ~ /-r' 5 <br />~ State Cert. .or R ist. t <br />L1 ~ City License Registration' ''$1 If <br />. ....................................... <br /> <br />COMPANY O-GrL /Ie fZJ-1 9121- 9-'7'6 'jt.) <br />State Cert. or Regist. f C /1C CJ 37? .!1'r <br />City License Registration . ~Jr <br />.......................................... <br /> <br />PLIDIBER <br />V Signature UJa 7' <br /> <br />OTHRR COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration t <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br /> <br />\ <br />\ <br />\ <br />\, <br />