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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />C\ e.Ve UJj <br />Lvi* () ~ <br />:;2/e&fY tkUQW <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL 1.0.' (7~ -~l" - ;11 -0010 - D5I Oo....co::o <br />WORK PROPOSED :~w Constructi <br /> <br />OWNER'S NAME <br /> <br />vS~17 <br />~3 ' <br />PHON;-YP~ <br />~ V f4J-k -.x -(~~ pj) <br /> <br />OWRER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROK PROPERTY TAX NOTICE) <br /> <br />_Addition <br /> <br />_Alteration <br /> <br />_Repair _Install <br /> <br />_Sign <br /> <br /> <br />PROPOSED USE: _~ng1e FaatlY <br /> <br />_Kove <br /> <br />_De.olish <br /> <br />_KIF <br /> <br />_' of Units _K/8 <br /> <br />_ec:-ercial <br /> <br />_Indust. <br /> <br />____Swi.. Pool ___Other <br /> <br />~estaurant & Health Dep, ,ent Approval <br />DESCRIPTION OF WORK: f) 'J:Yav) ~0/V;YlY I w;ryjO\SJS (;?l'rofct/ ~ 1l)t:Jlb) <br /> <br />BUILDING SIZE: J.G:, X 0 . ;:) 015 Square x~"..t, rg Height ;::)t(SH'?)b cR:.Pete./ <br /> <br />RESIDERTIAL: <br />COHHERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SET <br />ATTACH (3) SETS OF BUILDING PV <br />PROPERTY SURVEY REQUIRED FOR A l <br /> <br />,~ BUILDING PLANS & (1) 'SET ENERGY FORKS. <br />; (1) SET ENERGY FORKS. <br />ZW CONSTRUCTION. <br /> <br />~UILDING <br /> <br />$ <br /> <br />1175~ <br /> <br />PERKI T:i.,,REOUESTED <br /> <br />Va}'<ltion of Total Construction <br /> <br />'RI.P.CTRICAL <br /> <br />AttP Service <br /> <br />Plorida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-.JIECIIAI({CAL <br /> <br />$ <br /> <br />Valuation .f Mechanical Installation <br /> <br />_PLUKBING GAS ROOF ~G <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRucnON: ____Block _Fraae _Steel <br /> <br />Other <br /> <br />FI1IISHED FLOOR ELEVATIONS: <br /> <br />Fl' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />rfg;)-~:r'l5 ' <br /> <br />i <br /> <br />RmI.DER <br /> <br />CONTRACTOR SECTION <br /> <br />COM !',NY y~ 4 OY>')fnOY>) <br />~~ ~ Stale Cert. or Regist. . <br />City ,~ .~ '~ense Registration' <br />.....................*.. ;<'" 'It**..**.*****..* <br /> <br /> <br />Signature <br /> <br /> <br />'RI.P.CTRICIAR <br /> <br />COKPMd <br />State .eet. or Regist. , <br />City J 'ense Registration , <br />*.......**...*********...**.****..******** <br /> <br />SilmAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />Stat.., Cert. or Regist. . <br />City License Registration' <br />.*.*......*******.**.*******...**********. <br /> <br />Signature <br /> <br />!lECllARlCAL <br /> <br />COMPANY <br />St,,'i.e Cert. or Regist. #I <br />City License Registration . <br />.....**...*...*.***..**.****.**.********.* <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration' <br />.****..**************.********..**~*.*.*** <br /> <br />Signature <br /> <br />,>. <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKlT OFFICER. <br />