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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />:rl ,'rib <br />t L -' <br /> <br />: <br /> <br />OWNER'S IIAHIl &:~~ \v.)e~ &<::ce <br /> <br />OWNER'S ADDRESS 3'1 L\ 1...\ 1'") ~ ~v..J.. ~ ' <br />~ <br />JOB ADDRESS S 1 <-\ '\ '6 - ~ ~ ~ J\ J\ -^-^ CJ:. <br />3' c) <br />LEGAL DESCRIPTION: LOT(S) ~ BLOCK <br /> <br />PHONE -, ~ '~ .~'l ~ y; <br /> <br />SUBDIVISION W (D <6e WOO D <br />PARCEL 1.D.# \ D -~ \0 ~ & \ - 6 \QO "OCbOC' 0 ~SO (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction ~ddition _Alteration _Repair ____Install <br /> <br />_Sign <br /> <br /> <br />PROPOSED USE: ~le Fsaily <br /> <br />--1fove <br /> <br />_De.aolish <br /> <br />_M/F <br /> <br />_' of Units ____M/H <br /> <br />_ec-ercial <br /> <br />_Indus t. <br /> <br />_Swim. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCIlIPTION OF ~: - ~ ~. < <br />BUILDING SIZE: -\!J- X 1D\ -:- ~ Square Feet, 5 <br /> <br />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 />~WIRG <br />____ELECTRICAL <br />-KECllAlfICAL <br /> <br />PERMITS REOUESTED <br /> <br />$ <br /> <br />& COO <br /> <br />Valuation of Total Construction <br /> <br />AHP Service <br /> <br />Florida Power Corp. <br /> <br />~R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS <br /> <br />ROOFING <br />b:sae _Steel <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block. <br /> <br />Other <br /> <br />FDUSHED FLOOR ELEVAnONS: FT . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />~ <br /> <br />YES NO <br /> <br />*************.......*....*.*.*...**.***..* <br /> <br />CONTRAGTOR SECTION <br /> <br />IllllL\lER ~ COKPANY 'K'1'fV\"'N COtVS~cV(jN <br />- \ ~ ' State Cert. or Regist. # C~C~o 3S134- <br />Signat~ - ..( City License Registration # 27 <br />***************************************. 7< <br /> <br />ELECTRICIAN COMPANY 'iY\CA.A~ ~ ~ <br />./:) . ~ .;-;:; State Cert. or Regist. # f tZ. -D01344ot <br />Signature I ~. C../ ~___' City License Registration # ~ \ \ <br />***.****.******.*....****************.**.. <br /> <br />PLUMBER <br /> <br />ru/k <br />, <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration f <br />************.....*.**.*****.*.*..*..****** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />N(A- <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration . <br />*****....***********.********.****.******* <br /> <br />OTHRR COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration # <br />*************.**.*****.***********..*.**** <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />