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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRH1LLS <br />BUILDING DEPARTMENT <br /> <br />. ;2 0: (.1---D <br />-n r- IO~/-7" <br /> <br />OIINER'S IIAIIIl ~~ q" ~fT ~~ <br />OWNER'S ADDRESS ICJbSI ~ IS.. J)~ <br />iD4-0~ \-e..~L~~cL ~-~ <br />, <br /> <br />PHONE <br /> <br />~9J-?~bi <br /> <br />.. <br /> <br />LEGAL DESCRIPl'ION: LOT(S) 3 A <br /> <br />BLOCK <br /> <br />~J~> <br />, <br /> <br />SUBDIVISION S/Lv~ - OA,($" <br /> <br />JOB ADDRESS <br /> <br />PARCEL I.D.' O~-~-~\ -O\~O -~-n~'DV P-r (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED: X New Construction -Addition -Alteration _Repair _Install <br /> <br />_Sign <br /> <br />~ove <br /> <br />_Deaolish <br /> <br />PROPOSED~E: ~SingleFaai~ <br /> <br />~M/F _' of Units _M/H <br /> <br />_~ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />VII/AS ,c <br /> <br />SljJj~ <br /> <br />r,l.}/'!}; 0/ <br /> <br />R.~-s" <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. _ ~~l_' ~ <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. _ .. \ <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />_BUILDING <br /> <br />PERMITS REOUESTED <br />$ ~q Ot":JO Valuation of Total Construction <br />/!:;O AKP Service X Florida Power Corp. <br />S ~ ?CJO Valuation of Mechanical Installation <br /> <br />W.R.E.C. <br /> <br />_ELECTRICAL <br /> <br />_MECHARI.CAL <br /> <br />_PLUKBING <br /> <br />GAS <br />X B10ck <br /> <br />.f~JZo ROOFING <br />_Fraae _Steel <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: <br /> <br />Other <br /> <br />FDUSBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJEct' IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br /> <br />CONTRACTOR SECTION <br /> <br />COKPANY ~ ~ 4~~~ <br />State Cer or Regist. , c.t;.ca3~f?cJ <br />City License Registration' /1.$ <br />***************************************** <br /> <br />RT.RCTRICIAN COMPANY .5 ~ 5" /:::= lee r ~ .t-,;c... <br />;J:2. /a~ State Cert, or Regist.' G'J( <>00 "-t>YJ- <br />SiQfUlture - /'e." City License Registration' .7<n:? <br />**************************************** <br /> <br />~ <br /> <br />PLUMBER COMPANY #~ C-Yl r 7Z~ <br />./ State Cert. or Regist.' ./ 6G S- <br />Signature /1~ If] 'J f.-e-t./.lA/ City License Registration i / )? <br />****************************************** <br /> <br />KECHANICAL;J~' " COKPANY e c_ A (c CJC). <br />State Cert. or Regist. t Ac 0 .~ L 1./ <br />Signatur . City License Registration' ~q.2:> <br />****************************************** <br /> <br />,,// <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration t <br />*****************************************~ <br /> <br />Signature <br /> <br />-...,~_.,._" <br /> <br /> <br />_~Rmio+m.~B. y <br />SDIl*I 00. ......; - "" <br />_t",....,,, e..'....""".... ",. <br /> <br />- <br /> <br />r <br /> <br />PEBIIIT OFFICER~"'-I <br /> <br />.,. <br />