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<br />.. .. 0, t'''' <br /> <br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S ADDRESS <br /> <br />g~Vi\"1.,t&~r he..flcS"", <br /> <br />:$ q L. ~u C "'" n L <'l/ <br />, <br />SA. f"VV-e:- <br /> <br />Vi t'\ t-c"" <br /> <br />PHONE <br /> <br />OWNER'S NAME <br /> <br />Ro... J <br /> <br />~ 5'" 'f <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br /><;, <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_M/F <br /> <br />_, of Units _M/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_swta. Pool ___Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <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 />~ELEC1'RICAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />( C'~ <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHAIr.lCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />::~~~~ <br /> <br />COMPANY~ ~ r- ~ <br />State Cert. or Re~is t. f ; 0 ~ e/ /) 61 <br />City License Registration' 1~7 <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration . <br />***********~****************************** <br /> <br />OTHF.R COMPANY <br />State Cert. or Regist. I <br />Signature City License Registration I <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />