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<br />OWNER'S NAME . <br /> <br />APPLICATION FOR PERKlT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />C~.-rd r:l ;t,e.r-z.-o..J ~ /;r~H~. 7J"L ~/J-'6~ <br />;7 k ~:> ~/tt:.. e6A/ fLo tp~ ,8 /Z- -Z - H;-/(5- 37.>;J So- <br /> <br />" <br /> <br />>A~ - <br /> <br />tf - /J-- 17' <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) sL( BLOCK" SUBDIVISION ~uJ fI-a,c./~ ~ c:- <br />PARCEL 1. D.' 31-;;2 s- -.;) 1- 0 0/0 -0/;;6 () - f Y (OBTAIN FROII PROPERTY TAX NOTIes) <br />WORK PROPOSED:-rNew Construction _Addition _Alteration _Repair - ~~l <br />_Sign ---1fove _Deaolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />_M/F <br /> <br />_' of Units A..M/H <br /> <br />_C~ercial <br /> <br />_Indust. <br /> <br />_Swim. Pool ___Other <br /> <br />_Restaurant & Health Department Approval /' <br /> <br />DESCRIPTION OF WOIlK'. /Joz-o .6Y/,f7 ~ '>? 71 ~ ;8>dM.c ~ ll'<:/l.~;vt <br /> <br />BUILDING SIZE: UX ~ cf.. Square Feet/?7 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 FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />V;UILDING <br /> <br />$ <br /> <br />~ St}O <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AHP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----1fECHAlUCAL . $ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br />liLv ------v--Uther <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_FrUle _Steel <br /> <br />FlRlSHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />-K. <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />~ ~ <br />BUlIJlEl\ ~ CllIIPANY />7,,' / ",",c. E'1"-71];.<:- "a -<.-, zxr c:: <br />/ .. i .. State Cert. or Regist. , IC.K a> 0 9- '/ f(-- <br />Signatur~~_~ , Gity Liceose Registratioo' 7~t2 <br />.......................................... <br /> <br />ELECTRIC~ <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration # <br />.......................................... <br /> <br />Si2Dature <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 />OTHER <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # ____ <br />.......................................... <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERI <br /> <br />lCER. <br />