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<br />'.... .,:, <br /> <br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME <br /> <br />G l'€A-iV ci I-!CJt!..1 ~ ONS <br />p. 0 r~'f. ;)';}.'fS- (;;)AJ,z CTy <br />7 b if ~ GtG$S AJ$" t...o~ Ii. I:J tZ. <br />S? <br /> <br />PHONE <br /> <br />35;). -r~3-17Jt <br />33~2-.c <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />GIf;A-;V J 1/a~1 'UJ )~ <br /> <br />PARCEL I. D.' 3 if . :J.S'" J. J - 6 0 I ~ - 0 I 30 C) - S"i' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition --...Alteration _Repair _Install <br /> _Sign. _Move _Deaolish <br />PROPOSED USE: _Single Feaily _M/F _' of Units ~/H <br /> _ec-ercial _Indust. _Swill. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: S-~/vp t> $'"di) ") <br />BUILDING SIZE: d-.L{ xt..fD, 9~tJ Square Feet. 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 FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING $ Valuation of Total Construction <br /> <br />~ELECTRICAL I S() AIIP Service +FIOrida Power Corp. W.R.E.C. <br /> <br />.LMECHANlCAL $ /,. .2. .::>-0 Valuation of Mechanical Installation <br /> <br />~PL~ING GAS ROOFING SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel Other <br /> <br />YES <br /> <br />-if <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />F1' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA "I <br /> <br />....*........*..*.............*........... <br /> <br />Bun .oER <br /> <br />~gnature <br /> <br />CONTRACTOR SECTION <br /> <br />COIIPAIIY ~.u A7. r/ .5 <br />~ State Cert. or egist.' <br />GJo-r--l2 W City License R gistration f "$IX <br />... *....***..*..*.......**.*.....**.....* <br /> <br />RT.Io:CTRICIAR COMPANY lie 12 /{ Q .p."j .e I- HT/fI:1J J,o '- <br />~ L) /7/"J State Cert. or Regist. Ese> 0000 ,( <br />SilmAture ~ {P..e.er e:;1"f.;t,"- City License Registration . Ii,! <br />......*..*...................**........... <br /> <br />rmulIII COIIPAIIY ~ /J-t, /i .5 <br />/' . ~ State Cert. or egist. t <br />V Signature W ~ City License Registration' 11./ ~ <br />..:-. ..~.................................. ' <br /> <br />COMPANY /l-c e_ 1?(2fl}-tr9-e}-~7/o~ +~ C'_ <br />State Cert. or Regist. '. <.:. /?Co.J7l-SS- <br />City License Registration . s;- <br />.*......*.*.*...**....*..*......*...*.*... <br /> <br />MECHANICAL <br />Signature C~ 114d't.Art-- <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />*.*.*.**....*...*.**.*....***.**.......... <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />