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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE <br /> <br />~ 2(Cke~ <br />0'(.( /'( <:::- fA (I <br />h c ()~ <;~.4 it (;.)0--- 12 ~ <br /> <br />PHONE 8f, '( - ~ ?s.... 7'-i 1C, <br />~ ~'- ..? ..:?~O? <br /> <br />OWNER' S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRlPTION: LOT(S) \ J- '- <br /> <br />BLOCK <br /> <br />SUBDIVISION ,<; J-/.J.. '>A ~v- R'c <br /> <br />PARCEL I. D.' U 2. ~ Z ~ - Z I. 00 I g - oaa (50 - 0 0 <br /> <br />(OBTAIN FROM. PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ~teration ~epair _Install <br /> _Sign -'love _Deaolish <br />PROPOSED USE: _Single Faaily _M/F _' of Units _M/H <br /> ~~erCial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant.. Health Departaent Approval /" <br /> <br />DESCRIPTION OF WORK: T....>k/< QI--- /\2...e}~<.J\.I\t)-.\.~"p.J ~y <br /> <br />BUlWING SIZE: ~O X (c.xJ, ~ooo Square Feet, I'{ Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~)) ~17s\.s eLf'-- <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ cJ~o_o <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Valuation of Total Construction <br />.i.... <br />~ Florida p~er Corp. <br /> <br />W.R.E.C. <br /> <br />---1IECBARlCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUKBING GAS ROOFING <br />TYPE OF CONSTRUC'llON: -C:.Block _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FlIIISBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREAT ~ <br />YES NO <br /> <br />****...*******.*..*---_..._-_._-------_.** <br /> <br />CONTRACTOR SECTION <br /> <br />RUTlllER ~~ ~ COIlPAIIY 2vr.tll L E ffi7/ <br />State Cert. or Regis t . . c.. ~ c.. [) '2. f:j c../ "( <br />Signature ( City License Registration' 2- ~1zf <br />-* *..._*****.*******.*.*._******--*-* <br /> <br />1.,../"- <br /> <br />=~ COHPAIIY ~ c~ <br />- State Cert. or Regist. . <br />ure . a%~ City License ,Registration . <br />. *.*..............**...***;. *****...**.* <br /> <br />PLUKBER ~~ COIlP /, V U liz- <br />State ert. or Re ist. , C <br />Signature -"'?~--=--_ City Li,ceose Il.egistration . ) I' "3 <br />* ....***..*......................._..... <br /> <br /> <br />""","'". <br /> <br /> <br />~~ <br /> <br />Signature <br /> <br />4L i Y- COIlPAIIY I~ re <br />State Cert. or Regist. t <br />,. City License Registration' <br />**.**.......*....*..*......*.*.........*.* <br /> <br /> <br />MECHANICAL <br /> <br />OTRRR <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration I <br />.*..*...........*.........*..............* <br /> <br />APPLICATION APPROVED BY <br /> <br />PERHIT OFFICER. <br /> <br />l Y2- ~ k}-~\_)7k:-~ 5 ~(/I {r <br /> <br />fJ~'L C;~ <br />