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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAKE <br /> <br />~)a..~ \6\\ {c1-e,ll <br />3l?'-ISI ~O~"'1 ?o,q,,{ 51{ <br />~ F1DV'~a. S e4k tku.se- <br /> <br />PHONE(~i)) '1~).-723Y <br /> <br />OWNER' S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />3 f6tj-S-/ Cu'-'\n-i J f?4. Sr <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration ~Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_DeIIOlish <br /> <br />PROPOSED USE: _Single F8IIily <br />~eo..ercial <br /> <br />_KIF <br /> <br />_' of Units _K/H <br /> <br />_Indust. <br /> <br />_Swu.. Pool ___Other <br /> <br />L..Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: -r \.oL.IO) N~ C-''''c....t.J..~-+ <br /> <br />\ -3D A\.~ 1-,;)0 At"f\p ~.- .s~~ \C<.fo1e... <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 /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />-X-,ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUKBING GAS ROOFING <br />TYPE OF CONSTRUCTION: -X.-Bloclt _Fralle _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />Bun.nER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br /> <br />COMPANY '0 a ~c.CJ CD 11 s{ '" "c:.-~ :0 ^-. <br />State Cert. or Regist. , E R 00/ <f';J... '(0 <br />City License Registration' ':JD '3?- <br />****************************************** <br /> <br />PLUKBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration t <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration f <br />************~***************************** <br /> <br />OTRF.R COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration # <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERKlT OFFICER. <br />