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<br />. <br /> <br /> <br />iR( if ,5. <)!(}y ~ <br />f 1/7' 3,-l cY'" <br /> <br />OIillER' S IIA1lJl ~eu i tV IQ " /"VI AI\J PHONE l 'i('3, , " $' I 7 <br />OWNER'S ADDRESS ~ 41S~ ~ ~~ - ~~~?A <br />JOB ADDRESS "S'l4.0D . ~v:>c~ ~ <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />LEGAL DESCRIPTION: LOT(S) +~ BLOCK SUBDIVISION ~(D~olooOD <br />PARCEL 1.D.# \D.;}.lo., ~ \ - O\~b -OOOOO-a:18b(OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED: ~w Construction ____Addition ____Alteration ____Repair ____Install <br /> <br />____Sign <br /> <br /> <br />PROPOSED USE: ~1 e F8.Ilily <br /> <br />____Move ____D~olish " <br /> <br />____KIF _, of Units _K/H <br /> <br />_~ercial <br /> <br />____Indust. ____Swim. Pool _Other <br /> <br />_Restaurant Ii Health Department Approval <br /> <br />DESCRIPTION OF WORK: ~ ~~ <br />(' <br />BUILDING SIZE: .~(..". xSLf ,\64 ~ Square Feet, 8 Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ 531900 <br /> <br />. <br /> <br />:;loo AM.P Service <br />$ ~O <br /> <br />Valuation of Total Construction <br /> <br />_ELECfRICAL <br />-"ECllANICAL <br /> <br />Florida Power Corp. <br /> <br />.~.R.E.C. <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING SPECIALTY <br />TYPE OF CONSTRUCTION: ____Block ~r8.lle ____Steel Other <br />FIRISHED FLOOR ELEVATIONS: 5S- FT. IS PROJECI' IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER COMPANY ~~ ~ \..v.,~~ <br />_\......- n State Cert. or Regist. t ~-o~S\,,4- V <br />Signatur~~ City License Registration # ~ .;;;J..,yy <br />****************************************** <br /> <br />::~~~Q~~ ~ r~~'::;:=~~I~~1i V <br /> <br />*** ******* ~************************* <br /> <br />PLUMBER COMPANY~ \0&!h;~ <br />'" State Cert, or Regist. # R. F ~ ~~ ~ v--- <br />Signature 1:::::J~ \N&.Q.t~C~ City License Registration' 7 I 0 <br />****************************************** . <br /> <br />KEGBABlCAl" )d COMPANY_.~~~ ~u..b <t ~~ '_ <br />....--, /- ~ /J) State Cert. or Regist. 41 ~ -C)(-t3Q4-e ~- <br />Signature~ 'c-;( f ~ ~ City License Registration t ~ I f'J <br />*********** * **************************** <br /> <br />OTHER ~ COMPANY <br />. State Cert. or Regist. 41 ~ <br />Signat - City License Registration 41 <br />-*-**-****-******************************* <br /> <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />