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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />... -.... <br /> <br />JOB ADDRESS <br /> <br />5S)~ <br /> <br />80(~Q <br />kC~ 11 B\ \Jet. <br /> <br />( &r<L-+i- ~L ) <br />~l~ -1~~-Co~d~ <br /> <br />OWNER'S NAKE <br /> <br />('-hrl (' )es <br /> <br />PHONE <br /> <br />OWNER'S ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' (OBTAIN FROH PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair ~tall <br /> <br /> _Sign _Hove _Deaolish <br /> . <br />PROPOSED USE: _Single Faaily _H/F _' of Units _H/H <br /> Jec:-ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Deparbaent Approval <br />DESCRIPTION OF WORK: (;(ett~, *6-P 900 C)oil <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />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 FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECBARICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br />S's. I'T i L Other <br /> <br />TYPE OF CONSTRUCTION: _Block _Fr8lle _Steel <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />Bun.nER <br />Signature~OJtG~/) <br /> <br />CONTRACTOR SECTION <br /> <br />aJIIPANY:f=n(~ ~ ~ <br /> <br />~ ~ State Cert. or Regist. . n__ I ~.' =-.:0CXl1~ <br />~~~ - . - City License Registration . <br />****************************************** <br /> <br />F.T .RCTRlClAN <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />****************************************** <br /> <br />SiQllAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />OTHRR <br /> <br />Signature '.l;;bCJ./)tQQ..b ~ <br /> <br />COIlPANY P-.eo/le-t1- ~;c.. <br /> <br />State Cert. or Regist.' - D~I &) <br />City License Registration , <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />