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<br />APPLICATION FOR PERKIT a'1 <br />CITY OF ZEPHYRHILLS ... f <br />BUILDING DEPARTMENT 9 r ~ <br /> <br />~lW\~ . . <br />otY<6-'7$fo 0 \ <br />[ wh-evt. '( ec,c1V <br /> <br />OWNER'S ADDRESS SIt 4 <br /> <br />5 l \ L\ <br /> <br />JOB ADDRESS <br /> <br />< )fr v ,(,( I) 1 Y\ \ cMa elf- P Ct t <br />, <br /> <br />SUVJ)rt\.Qy +-h t \ D ( , <br />SC)(y"\ ().. 0 Y ~ l 1 <br />'2 q BLOCK 2s< <br /> <br />PHONE <br /> <br />J ~ 2 - ~ LI ')k <br /> <br />OWNER'S NAME <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />Dv <br />SUBDIVISION s:.umme.r H,' II Sob <br /> <br />PARCEL I. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />pt <br />WORK PROPOSED:_New Construction _Addition ---Alteration _Repair _Insta1l <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_De-.olish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_H/F <br /> <br />_' of Units <br />XSwia. Pool <br /> <br />_H/H <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Other <br /> <br />_Restaurant &: Health Departaent Approval <br />DESCRIPTION OF WORK: \ nsfq I \ I ~ r Ou{)CJ -PC;C-) I <br /> <br />3+!o <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />GOKMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />{S(Ott~ <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 />----1fEGllAlfICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIllISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECl IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRAClOR SECTION <br /> <br />BIJTT.DER Jo S \ mS COMPANY A ~ V crt; cPo 0 l s <br />-4 ~ #- State Cert. or Regist. . CPe,O$ b /' " <br />Signatur Yl\ _ (1 -lfnU City License Registration . ::L~ .J.. () <br />****************************************** <br /> <br />RT.RGTRIGIAR H-QuJtin'rfro'-l COMPANY Haw tt' ("\ S <br />~ ~ State Cert. or Regist.' =L <br />SignAture . ~ JfVlI' City License Registration . <br />***************************************** <br /> <br />--A. V <br /> <br />/ <br /> <br /> <br />........---. <br /> <br />Signature <br /> <br />,jo Slh\ ~ <br /> <br /> <br /> <br />PLUMBER <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State C~t. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />. <br /> <br />OTRRR 1_ ~ OQ~n <1- COMPANY t(b( n '~~rn I <br />. V'~,\..X~ , . State Cert. or Regist. f <br />Signature ~ I'D l ~ Th rl ftlXYll f\<..(t:l City License Registration . <br />****************************************** <br /> <br /> <br />/ <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />