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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />\1 /1'/ <br />~/ <br /> <br />/!111(~ <br />9~O,"763 <br /> <br />OWNER'S NAME <br /> <br />-5v JJ+"'\Jst <br />OWNER'S ADDRESS po \ S ~ CS<'dO les V J'.€ .( 1 34 ~ c>S <br />JOB ADDRESsS ~ 3 S U 5 ..3 C> \ ~ ..J!/d{J <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction _Addition ----^lteration _Repair ./ Install <br /> <br />~ign <br /> <br />--"ove <br /> <br />_DeIIOlish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_KIF <br /> <br />_' of Units _K/H <br /> <br />_ec:-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: e r <::<.t WAI\ S' \ c::-J <br /> <br />BUILDING SIZE: /'6 X 1.3 /1, Square Feet, :3- I 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 />PERMITS REOUESTED <br /> <br /><BUILDING <br />"'2\ ELECTRICAL <br /> <br />$ <br /> <br />/75"0 ~ <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHAliICAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUCTION: _B1oclt _Fraae _Steel <br /> <br />Other <br /> <br />FIllISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />Signature <br /> <br /> <br />COMPANY tv ~:s1'C~~/ SIC/\7S <br />State Cert. or Regist.' E.,s-Oddd d 1(' 7 <br />City License Registration' \""1 "7~ <br />.......................................... <br /> <br />Rlffl.ng <br /> <br />:~:~~ <br /> <br />COMPANY 4> E.$'7 ('""1ft' ..uT/t.tD/ .slc~ S' <br />State Cert. or Regist.' t:S6dd4 d Y'7 <br />City License Registration f 1'77S' <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 />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration t <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />