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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPllYRHILLS <br />BUILDING DEPARTMENT <br /> <br />'\ <br /> <br />OWNER'S NAKE Si ~ V ~ eMK.S A ~<s ~ '\ <br /> <br /> <br />OWNER'S ADDRESS ~. C}, ~~ \ \ t.s ~ <br /> <br />PHONE <br /> <br />JOB ADDRESS"'rc."X.. M.Oorl <br /> <br />Sl~"l, <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D.' <br /> <br />(OBTAIN FROK PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_KIF <br /> <br />_' of Units _K/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swill. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: E:. L,~~. <br /> <br />Se\fi..\')\(.,~ r'll.) ~c)(..~l\... <;.,IE:.....\ ~\L w~~ Cc..c.x:::.~"?, <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />-- <br /> <br />- <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <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 />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHAlUCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUC'l'ION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />Fl" . <br /> <br />IS PROJEC'l' IN FLOOD ZONE AREA? <br /> <br />**..***.**..........*....***..*........... <br /> <br />YES NO <br /> <br />CONTRAC'l'OR SECTION <br /> <br />BUILDER <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />...*.............*..........**............ <br /> <br />Signature <br /> <br />ELECTRICIAN <br />SiQflAtu~~ <br /> <br />COMPANY 'L...- \..\\ \.L ~ E L ~ c "( , S' &~ \J , <br />~ ' S....e Cer<. or Regis'. # <bnq ",-(Chi;- <br />~ City License Registration' q c,-' <br />. ....................................... <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />..*.....***........*....**..*.......*..*.. <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />..*......*..*.....*...*.*..............*.. <br /> <br />Signature <br /> <br />OTHRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration # <br />***...*.*...**....**....***.*..*........*. <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />