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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRHILLS <br />"BUILDING DEPARTMENT <br /> <br />OWNER · S NAKE Or/) I....,/(;I ~- g /0 j S () ,'>'/ /l."9./Jc ~ c-....k/ ..0 <br />/ <br /> <br />OWNER'S ADDRESS Y'&/> LJ/.r;5 5'o~ <br />JOB ADDRESS l.f,s-SO iJ/05" So"..-} <br />LEGAL DESCRlFl'ION: LOT(S) <br /> <br />IJ/t/ci ~ ot","'# <br />il/cf# S- <br /> <br />PHONE? cr f'~ Ot? [)7 <br />J.JSY/' <br /> <br />a. <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />.." <br /> <br />WORK PROPOSED:_New Construction _Addition -^Iteration ~Repair _Install <br /> .. <br /> _Sign _Move _Deaolish <br /> . --x""M/F <br />PROPOSED USE: _Single Faaily _, of Units _M/H <br /> ~, <br /> _Co..ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant Ii Health Departaent Approval <br /> <br />DESCRIFl'ION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />~oo Square Feet, ./0 Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />('>(.') <br />$ s;- J 9'0 .- <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'l'RICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECllAlfICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_Pl.UHBING <br /> <br />GAS <br /> <br />K ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT" <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BIJTI.DER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />RI.RCTRIClAN <br /> <br />SignAture <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />*************************************....* <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert" or Regist. . <br />City License Registration t <br />*..*.*****..***********.*.*.**..**...*.*.* <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />*.*.*.*.***~**.....**...******...*......** <br /> <br />COMPANY T..'''/V ,.lUrJc;1 /):}/.;I <br />State Cert. or Regist. . He 003.. ~'>/!>- <br />City License Registration # Jl90 <br />.*.**...*..*.*.*..*.*.*..***..*.***...... <br /> <br />Signature <br /> <br />OTRRR Fool";;' <br /> <br /> <br />Signature <br /> <br />PERHIT OFFICER. <br />