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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPllYRHILLS <br />BUILDING DEPARTMENT <br /> <br />~/(::z;tS 9 '7 <br /> <br />OWNER'S NAME P/"IC ,/VtJ4RKZ;T -S6)lJA~C <br />OWNER'S ADDRESS 38/3S /"1J?.eKC'T.s (j)V#j; <br />JOB ADDREss.18) co - 3?i IJ 7 1"1 Hex /rf .s. (;) vA.et=" <br /> <br />PHONE R'/3 - 78'(J- 8'77V <br />26"'I'IIYRIIIII~ ;;CL . S3sVo <br />, <br /> <br />7E"PIIYRlh//s, /-t:, ssSYc <br />, <br /> <br />LEGAL DESGRIPl'ION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D,' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction --Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_DeJlolish <br /> <br />. <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_M/F _' of Units ---.Jt/H <br /> <br />_eo..ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESGRIPl'ION OF WORK: FI,e~ SP.f'I/IIK/Z:,.e /Sotl'cYVl'7'OR",-'Y6' <br /> <br />SYS?EP"-/ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COMMERCIAL <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />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 />V ELECTRICAL <br /> <br />$ <br /> <br />~ <br /> <br />26 90,.. De Valuation of Total Construction <br /> <br />AMP Service Florida Power Corp, <br /> <br />W.R.E.C. <br /> <br />_MECHAIO:CAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUHBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF GONSTRUcnON: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIRISHED FLOOR ELEVAITONS: <br /> <br />FT, <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUTlllER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />F.T.F.C'l'RTCIAN <br /> <br />Sian$lture d~w- <br /> <br />COMPANY /I c~V2?Y WELL // {.,8 c <br />L/ '" State Cert. or Regist.' E~CJo()c. Y'{).,) <br />C~ City License Registration f ') t? ~ ~ <br />****** *********************************** - . <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert, or Regist. , <br />City License Registration . <br />************~***************************** <br /> <br />Signature <br /> <br />OTRF.R <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />