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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME ' <br /> <br />G ~ /L/ c:! 1-(0 /C- { 2-0 ,A/ -5 ____* C~ PHONE <br />,/ <br />(/,0, ~~ /'cYY7 ?~~c/& <br />4~ /(e; /b ( 24 A/.r (/3/1" c! <br />Sf <br /> <br />~'/ fc?r- / c1,6~ <br />3' 35>" 31'- /E- Y 7 <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />r::.r/~~ d ~,r-ru~-",' <br /> <br />PARCEL I.D.' 3L(-2S-~(-ao/c) -C>t''360 _ .>~ <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ____Addition _Alteration ____Repair - ____Install <br /> <br /> _Sign ----..Move _Demolish <br />PROPOSED USE: ____Single Family ____M/F ____, of Units ~/H <br /> ____Co...ercial ____Indus t. _Swim. Pool _Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />DESCRIPTION OF WORK: <br />BUILDING SIZE: Rx 6 L/,' J 75 Z-Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL ATTACH (J) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />____BUILDING <br />0LECTRICAL <br />V'MECHANICAL <br />vriUHB~NG <br /> <br />$ <br />I S-d <br /> <br />AMP Service <br /> <br />Valuation of Total Construction <br />X Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />/,2.. " <2) I <br />, <br />, <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_FrlUle _Steel <br /> <br />I1/l Ie 'J <-- <br />( <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA'? <br /> <br />cV <br /> <br />...................................*...... <br /> <br />YES NO <br /> <br />Signature <br /> <br />wc~ <br /> <br />CONTRACTOR SECTION <br />~,~ c <br />COMPANY ,6 u l/!?/Z. ;::;1/0 /' /' /Y) , H - S - <br />~ State Cert. or Regist. , ~lr _ <br />L2 City License Registration' _____ <br />.... ..............**********.**.******.*. <br /> <br />BUlIJ)ER <br /> <br />ELECTRICIAN <br /> <br />COMPANY ;::; c ri: (<(;- Pn( ~ <br />~ I ~ State Cert', or Regist. 41 ( <br />C-/UAA:-- City License Registration' .. <br />................************************** <br /> <br />-::TN C- <br />/8'7 <br />.. <br /> <br />SiRllature <br /> <br />, <br /> <br />COMP~ /~v~h~/'/ A f..f)/' <br />~ State Cert. or Regist. , . <br />Signature [, )(1)''''----- City License Registration ## itr <br />.*. .*....******...****.....*....*.****** <br /> <br />MECHANICAL COMPANY ",/Ie € _ w"c~( 7' J <br />AI /J j) n f)/'l State Cert. or Regist. #1 <br />~ q~ City License Registration' <br />..*.***...*.~**.**....**.*............*.** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />7/l/p <br />___....--.._.L---_~, <br /> <br />*"'1 <br /> <br />OTIIER COMPANY <br />State Cert. or Regist. '__ <br />Signature City License Registration <br />....****.**.**.********.***.*****....***~ <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />