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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE <br /> <br />J / ~ 1/4., <; !-o....; <br />57/~ 60~R <br /> <br />5' s-4-A.1,.e, <br /> <br />PHONE )),~.;z - 9 C) ., '7 <br /> <br />OWNER r S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D.# (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> _Sign -Hove _Deaolish <br /> . <br />PROPOSED USE: _Single Family _KIF _' of Units _K/H <br /> _eo..erciaI _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: ;z -; ...,. dxJ 4Y'C c Iz c7:7 ~. <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 />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />t)-v <br />$ ..2 ~ ? 5:-:;:-I"JV Valuation of Mechanical Installation <br />l <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />'typE OF CONSTRUCTION: _Block _Frame _Steel <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 SECTIOli <br /> <br />BUILDER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />*.**.***..********************.**.*******. <br /> <br />Signature <br /> <br />, <br /> <br />RT.RCTRIClAR COMPANY~'" ~€ (N/I/I/I) A-L { FLEe flr,~,f L (c...ft; <br /> <br />, tl - State Cert. or Regist. # <br />SiQQAture/~c~( ( {eL~ u...ef City License Registration' (J 70<. <br />*..**********..***********.****.*********. <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration I <br />****.***************.**.******.*********** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br /> <br />K:'.vC;-<!7 C~~ <br /> <br />State Cert. or Reglst. # cJ cf) ~.::z <br />City License Registration I , <br />*.*.*********.***********.....*******.*.*. <br /> <br />COMPANY <br /> <br />OTHF;R <br /> <br />COMPANY <br />State Cert. or Regist. I <br />City License Registration # <br />**********.****************************..* <br /> <br />Signature <br /> <br />",.-,..".. <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />