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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />( ~,~) <br />o 6CJ - O<OOG:, <br /> <br />, Ciry <br />')~./ , <br />~/r;f' <br /> <br />OWNER'S N~\ '\ --e. \ \f\ d~ Me-I \ e c~ <br /> <br />OWNER'S ADDRESS G 9() '\ f\J L ~ ~ e.. D(L . <br /> <br />JOB ADDRESS G ~ 0 If\). L ~ Ie e.. \) e. <br /> <br />LEGAL DESCRIPTION: LOT(S) if 10 BLOcRXrYXSDBDIVISION <br /> <br />PARCEL I. D. t () 5 'L (r Z \ (') I 5<0 CbCco () '7 \ () (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition -.-.Alteration _Repair ~nstall <br /> <br />PHONE <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />. <br />PROPOSED USE: _Single Faaily <br /> <br />_eo..ercial <br /> <br />_M/F _' of Units _M/H <br />_Indust. ~Wia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRlPTIOII OF liORK: C mC\ -f ~ c: ~ ,<Y) '~ fbO L <br />BUILDING SIZE: X Square Feet, 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 /> <br />$ <br /> <br />/..s . t!J7}7:) . t9-O Valuation of Total Construction <br />, <br /> <br />AtIP Service ~lorida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_ELECTRICAL <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF COliSTRUCTIOII: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FltUSHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT III FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />BUILDER <br /> <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY <br /> <br /> <br />f'()(>(Cl t 10J In( - <br />/ <br /> <br />Signature <br /> <br />~ <br />G\S d <br />State Cert. or Regist. . <br />City License Registration t <br />***************************** <br /> <br />ELECTRICIAN <br /> <br /> <br />=~h~~2 t~~~~ <br /> <br />City License Registration t I "\ L <br />************************************ <br /> <br />YcoLs a #vi) Cc0PcGt f- /UI') <br />State Cert. or Regist. . <br />City License Registration t <br />****************************** <br /> <br />PLUMBER <br /> <br /> <br /> <br />v <br /> <br />Signature <br /> <br />KECHABICAL <br /> <br />COMPANY <br />State Cert. or Regist. * <br />City License Registration . <br />************~***************************** <br /> <br />Signature <br /> <br />, OTRRR COKPANY~& ~JI\. ~~. <br />(H'Q,) ~~ ~ State Gert. or Regist. tQ~i{"1'<{~ <br />Signature' G_ . City License Registration t 0 a... a~-, <br />*** ************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />