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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRHILLS <br />BUILDING DEPARTMENT <br /> <br />~ ?K F )~- - Cfl.<ffJ. <br />3~/'1-9/ <br /> <br />OWNER · S NAHB <br /> <br />JAIiJe! .> <br /> <br />v- '1k77) <br /> <br />~ A7 A/JI LJA?. <br /> <br />PHONE <br /> <br />OWNER' S ADDRESS <br />JOB ADDRESS & ~S:J . \T<eiJjI-(LI J ~J;tr/I <br />LEGAL DESCRIPTION: LOT(S) ,LIJ/ sS- BLOCK <br /> <br />SUBDIVISION 5T-f'I'J/.e.J.5 6tp...J II T5i~ t7Ats <br /> <br />PARCEL I. D. f ./ (OBTAIN FROM PROPERTY TAX NOTICE) <br />IiORk PROPOSED: v;;:: Construction ---.Addition _literation ~ir -Install <br />.. <br /> <br />..., . - <br /> <br />_Sign <br /> <br /> <br />PROPOSED USE: ~le FaailY <br /> <br />-Jlove <br /> <br />_D~lish <br /> <br />_M/F <br /> <br />_, of Units -Jl/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />,~ <br /> <br />_Restaurant &: Health Departaent Approval <br /> <br />,- <br /> <br />DESCRIPTION OF WORK: Ct!l;v51le<<CT......-'.uv Sr""~ ~...,;c.; ~S"~..se" <br /> <br />BUILDING SIZE: 67 X st; . d. </ / ~ Square Feet, 5" 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 />/ <br />_BUILDING <br />~LEC'l'RICAL <br /> <br />~~ <br /> <br />PERMITS REOUESTED <br /> <br />$ <br /> <br />200 <br /> <br />AtIP Service <br /> <br />Valuation of Total Construction <br />~orida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />.::lsOtJ. 0 " <br /> <br />Valuation of Mechanical Installation <br />~NG SPECIALTY <br /> <br />GAS <br />~oclt <br /> <br />TYPE OF CONSTRUCTION: <br /> <br />_Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />~ <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTIO~ <br /> <br />BUILDER COMPANY tt3:7.i!. ~ret:;(;/ ~ c <br />f2L-- State Cert. or Regist. f R.e-~oS-63LC <br />Signature ~ Q ./ - City License Registration f /32- <br /> <br /> <br />ELECl'RlCI611 / P COIlPANY A"O?e?; ~< <br />~ State Cert. or Regist. # (loOlll? 'f <br />Sian$lture City License Registration # Z-.(O Cj <br />......................................*... <br /> <br />~ <br /> <br />~ <br /> <br />.... <br /> <br />PLUHBER COMPANY ~(~..ver ~CA #1 8/ r-/ ~ <br />? tf2 .;:;~ State Cert. or Regist.' ("F~~ <br />Signature rY\.- ~ . City License Registration'.. I _ Cf <br />......*...**......................*..*~.*. <br /> <br />IIIlCIIAJIl~ COMPANY 5~ /Vir/V '5 <br />~ State Cert. or Regist. f <br />Signature .~ ~'7 · City License Registration' <br />..*...... ...*.*......................... <br /> <br />/ <br /> <br /> <br />/ <br /> <br />OTHRR <br /> <br /> <br />COMPANY &>2.ereeO ~C <br />State Cert. or Regist. , /6e- OOS-6:32h' <br />ity License Registration # / '3 2- <br />.......................................... <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKlT OFFICER. <br />