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<br />~ <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYRHILLS <br />BUILDING DEPARTMENT <br /> <br />. ('L~ <br />'& tr <br />sf/~fe <br /> <br />X OWNER' S NAKE <br />'f OWNER' S ADDRESS <br />'{. JOB ADDRESS S 7 / 1 <br /> <br />If A..i7P>0 ; ~ Hi j- ch !(.tJw ; 72 <br />(;/ 3z; /47( s7: Al, <br />qflt:5'T <br /> <br />PHONE <br /> <br />'7& /:; ?~otl <br /> <br />'f LEGAL DESCRIFl'ION: LOT(S) tf.- i-] BLOCK tJ-b <br />Y PARCEL LD.' 112&.~ Z/OO.' /pc J, tP&'t> 0(;> 'to <br />WORK PROPOSED :_New Construction ~ddition <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROK PROPERTY TAX NOTICE) <br />---..J\lte rat ion ~Repair _Install <br /> <br />_Sign <br /> <br />---"ove <br /> <br />_DeIIOlish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_KIF _' of Units _K/H <br /> <br />_~ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant &: Health Departaent Approval <br /> <br />DESCRIFl'ION OF WORK: . - <br />i ~ '\ ~k{ <br />'{BUILDING SIZE: 28 X ~ . ~ 4~ 2...-squa1e Feet. f3 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 />PERMITS REOUESTED <br /> <br />-LBUILDING <br />~ELECTRICAL <br />--lIECHAIIICAL <br /> <br />$ <br /> <br />Ii 7.ppp .#,) <br /> <br />Valuation of Total Construction <br /> <br />AKP Service <br /> <br />)t Florida Power Corp. <br />. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br />TYPE OF CONSTRUG'l'ION: -LBloclt _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FIRISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY 1Jl,4"t./L /5/ e:/c{" LI7u-~1 (0 <br />I..tf;~ ~ State Cert. or Regist. . R,f!;. (JOLt ~-pp <br />#: City License Registration' bl-/ & 0 <br />, <br />****************************************** <br /> <br />BIJTl.DER <br /> <br />i <br />\ <br /> <br /> <br />COMPANY M. ,...h~ E:I-L<..--+r-c'r..- <br />State Cert. or Regist. . h 0 <br />City License Registration . <br />****************************************** <br /> <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />****************************************** <br /> <br />OTRRR <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />