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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />;tPr <br /> <br />OWNER' S NAKR <br /> <br />~IU:S6jfOt-tAN 6ri~~11 PHONE <br />~IO . tqrH S',- 7~HiiLHlLi8 <br />~t <br /> <br />1 g-;r7l/ J d- <br />~ 33S"~o <br /> <br />OWNER' S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRI.P'IION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.'D.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~New Construction -.-Addition -.-Alteration -----Repair _Install <br /> <br />_Sign <br /> <br />--"ove <br /> <br />_Deaolish <br /> <br />PROPOSED USE:i _Single Fsaily <br /> <br />--,,'F _' of Units --"/H <br /> <br />I <br />i _ec:-ercial <br /> <br />_Indust. _Swill. Pool _Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />. _Restaurant I( Health Departaent Approval <br /> <br />~srA1J- 3bt ~ G' CHthN l.i~k AM- ct IW4U<. jJrrt. <br />(If.A7L OF t$ACL-l)I'1 <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS I( (2) SETS OF BUILDING PLANS &: (l) SET ENERGY FORMS. <br />COMKERCIAL: ATTACH (3) SETS OF BUILDING PLANS I( (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERHITS REOUESTED <br /> <br />~UILDING <br /> <br />,$ <br /> <br />Lf9~~ <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'fRICAL <br /> <br />AtIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CIIANlCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />~UMBDfG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel _FetJcE <br /> <br />Other <br /> <br />FIBISHED FLOOR ELEV~nONS: Fr. IS PROJECT IN FLOOD ZONE AREA? <br />..........................................BURTOftNC~~NC. <br />11315 STATE RD. 52 <br />HUDSON, FL 34669 <br />PHONE 813-857-1118 <br />FAX 813-856-6774 . <br /> <br />CONTRACTOR SECTION <br /> <br />Signature <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />BUrl J1ER. <br /> <br />'" 97 <br /> <br />RI.RCTRlClAN COMPANY <br />State Cert. or Regist. .' <br />SianAture City License Registration . <br />.......................................... <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Sigoatuxe City License Registration t <br />.......................................... <br /> <br />KECHANlCAL COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration f <br />.......................................... <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERHIT OFFICER. <br />