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<br />APPLICATION FOR PERKIT <br /><UTll OF ZEPIlYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWIfU'S MAKE JEN Gr <br />own- S ADDRESS 5/5" ( <br />JOB AOOUSS SAM ~ <br /> <br />LI N PHONE 818 - ,6 ~ -88% <br />2., CST S~ETlftPJ.4412J.HLLS I FL 3-e64-0 <br /> <br />LEGAL DESCRIPI'IONf LOT(S) <br /> <br />BI..OClL.--SUBDIVISIOH <br /> <br />PARCBL 1.>>.,-,2.. - Uo - 2./ OOlO::-OQ I DO - 01 an <br /> <br />(OBTAll1 PROM PROPER'!'Y TAX IiOTICE) <br /> <br />WORK PHOPOSBD:-Rew CoIlUr;uc;Uoo ~ition. --..Alteration ----Repair _Install <br /> <br />_Sign <br /> <br />--..Hove <br /> <br />..-D.-olish <br /> <br />PROPOSED USE: LSiogle Faahy <br /> <br />_H/F _' of Units _K/B <br /> <br />_eo-el'cia.l <br /> <br />..-lndust. _Swia. Pool _Other <br /> <br />_Ra.t.au~ao.t 61 Health DepaJ:taent Approval <br /> <br />DBSCRIPTION Of WRIt; S(!..(ZE:.E. N RooH <br /> <br />BUILDING SUE:~. 160 Square Feet.,.-ll.Jreight <br /> <br />IlESIDDTIALa ATTACH (2) PLOt PLUS ,& (2) SETS OP BUlLDINGPLAHS I: (1) SET EJIIEltGY FORl'm. <br />COIOIDcUL ~ ATtACH (3) SB'lS OF BUILDING PLANS a (1) SET EIlIDGY POMltS. <br />PROPERTY SURVEY ltEQUlRED POll ALL NEW CONSTRUCTION. <br /> <br />PERMITS B.I!lOUBSTED <br /> <br />LoUILDIIIG <br /> <br />s 3(cl15 ~ <br /> <br />Valuation of Total Construction <br /> <br />~LBCT.RlCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />_W.R.E.G. <br /> <br />-HBCIWI1CAL <br /> <br />$ <br /> <br />Value.Uon of Mechanical '1ostal1ation <br /> <br />_PLUtlBIRG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />tlUJu <br /> <br />Other <br /> <br />'n'PB 01' CXJRSrKUCTIOR: <br /> <br />_Block <br /> <br />_P~ _Steel <br /> <br />FIIIISIIBI) PJ.OOR ELEVATIONS; <br /> <br />PT. <br /> <br />IS 'PROJEcr IN FLOOD ZONB AJlEAt _ l <br />YES NO <br /> <br />...................................****... <br /> <br />Signat.ure <br /> <br />COllTRACTOR SECTIOn <br />C>1lIPAJlY; WI-l 1,..l\lUMlt,lUM / ~ CQLf M~ <br />State Cert. or Re&isa:. , f.,BCOO''f-lnj <br />City License R.aistraUoll # /9 70 <br />.*.............._..._.............***..... <br /> <br />BtnLDBR <br /> <br />ELBCTUCTAII <br /> <br />COtIPABY <br />Stat* C4iz:t. or .Reaist. . <br />, C1ty License Reaiau-aUoll . <br />*......................................... <br /> <br />Si-ature <br /> <br />PLUMBER <br /> <br />COKPAliIY <br />State Gert. or Reaist. . <br />City Licenae Reai.tz:ation . <br />.......................................... <br /> <br />'S igoature <br /> <br />..~ClWtICAl.. <br /> <br />J101fP":NY: <br />State Cert. or ReSlst. . <br />City License Regiatration t <br />*..*e..................................... <br /> <br />Slgoature <br /> <br />J1lIIB <br /> <br />Sisn-ture <br /> <br />COMPANY . <br />State C8rt.. or Regist. . <br />Ci1:y License llegistn.t.ion . <br />..-....-.............................-.... <br /> <br />APPLICATION APPROVED BY <br /> <br />PBRHIT OFFICER. <br />