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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />A I - C ~ <br />OWNER'S NAKE .AJ kLc= ~ F-oal ~IU JElL <br />OWNER'S ADDRESS S3S'-J bALLntvi .JJ:. '1 f S? <br />JOB ADDRESS ~ ArM. ~ <br /> <br />PHONE ~ ( 3 - -z- '54.... l..J 1 'f 7 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' (OBTAIN FROK PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction -^ddition ~lteration ~epair _Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_KIF _' of Units _K/H <br /> <br />_eo..ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />...\~ -=t-ItA-l\ ~ wA-llb <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square F~et, <br /> <br />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 />v~ BUILDING <br />VELECI'RlCAL <br />~Gwu.J.CAL <br />j.,~UMB~NG <br /> <br />$ <br /> <br />~ <br />1.8(90 <br /> <br />, <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: <br /> <br />_Block <br /> <br />_Fraae _Steel <br /> <br />Other <br /> <br />FIllISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />BIITI.DER <br /> <br /> <br />****************************************** <br /> <br /> <br />CONTRACTl!I\ s~ ;/.~ <br />COMPANY LlAJ AJ/A1&HAIl-C. COtJ s1etlL1ld\\.\ <br />'77 <br />COMPANY SA~ ANN 17L'~0Ttl) e- <br /> <br />State Cert. or Regist. . <br />City License Registration . <br />**************************************** <br /> <br />State Cert. or Regist. . <br />City License Registration . <br />*********************************** <br /> <br />/'I~I <br /> <br />/ <br /> <br />PLUMBER : i COMPANY NOs.{~s DA~'EIL <br />...... LJ J. State Cert. or Regist. . <br />Signature 7Jit.l>'-V.A... ( g-:l!'~ City License Registration t <br />/ ****************************************** <br /> <br />/'1 <br /> <br />/ <br /> <br />Signature <br /> <br />NJr <br /> <br />COMPANY C2:,1l\AJ--A,NJ -SLt::-er,U L <br />State Cert. or Regist. . <br />City License Registration . <br />************~***************************** <br /> <br />KEGBANICAL <br /> <br />OTRF.R <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />