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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPllYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OIINER'SIWIB 6l:7~~ N~:a~ <br />OWNER'S ADDRESS <br />JOB ADDRESS '0- 7 I, '? -- 9 .,.4 <br /> <br />PHONE <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ----.Al.teration ~epair _Install <br /> <br />_Sign <br /> <br />--1Iove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Fallily <br /> <br />_KIF <br /> <br />_' of Units _K/H <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDEBTIAL: <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 FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />" <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--1IECBANlCAL <br /> <br />$ ;:2 ,S-lJ _ o-l) <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fralle _Steel <br /> <br />Other <br /> <br />FllIISBED FLOOR ELEVAITONS: <br /> <br />FT. <br /> <br />IS PROJECf IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACfOR SECfION <br /> <br />RUTI.DRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />RT.R.CTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.......................................... <br /> <br />SilmAture <br /> <br />PLmtBER <br /> <br />COKPANY <br />State Cert. or Regist. , <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />IlECHANICAL <br /> <br />h .,c" " --J, ~ ").. ' <br />COMPANY ,../ t:'J A/ ..t/ (/ S Dl 7 ~c.J7V1 if",,/, J~-W1 <br />~ ti}.. State Cert. or IIegist. . <br />~ C?' City License Registration , 'J.. ~ Cp <br />, ~... .................................. <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />