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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME <br /> <br />rf ~~:fL <br />I <br />5c, i/ <br />, <br /> <br />r:z~~1 <br />" 7' h .--:::z-1T <br /> <br />PHONE r/ '3 - 75f'7r 7~ I ~ <br /> <br />OWER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />~--"'~~ <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 />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single FUlily <br /> <br />_H/F <br /> <br />_' of Units _K/B <br /> <br />_~ercia1 <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health DeparbDent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />~~.-' <br />- <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 />~LDING <br /> <br />PERKITS REOUESTED <br /> <br />$ 35V.o9 <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'l'RICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECllAllICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUC'l'ION: _Block _FrUle _Steel <br /> <br />Other <br /> <br />FIliISBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJEC'l' IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BunnER <br /> <br />Signature <br /> <br />j(~/ <br /> <br />, <br /> <br />COMPANY <br />~ State Cert. or Regist. . <br />City License Registration , <br />' **** ************************************* <br /> <br />RT.RCTRICIAH COKPANY <br />State Cert. or Regist. , <br />SignAture City License Registration , <br />****************************************** <br /> <br />PLUMBER COKPANY <br />State Cert. or Regist. , <br />Signature City License Registration t <br />****************************************** <br /> <br />MECHANICAL COKPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />****************************************** <br /> <br />OTHRR COKPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERHlT OFFICER. <br />