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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAKE <br /> <br /> <br />PHONE 7Ra.-a~7~ <br /> <br />OWNER · S ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL I.D.' 03 ~ (g <br /> <br />~o <br />Q./ <br /> <br />61 <br /> <br />B~C:>"C:> SUBDIVISION ;Z~F'h'lr tf.'1e. <br />eikr I <br />"(')ot)(') (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />JOB ADDRESS <br /> <br />tJl S () <br /> <br />WORK PROPOSED:_New Construction _Addition ---^lte rat ion _Repair _Install <br /> _Sign _Move _Deaolish <br /> ~ngle . v<: <br />PROPOSED USE: Faaily _M/F _' of Units <br /> _eo..ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant Ii: Health Depart:aent Approval <br />DESCRIPTION OF WORK: ~1 U{J Iq'lS fit-1m. Itltrbor ffIJft1e- <br /> <br />, <br /> <br />BUILDING SIZE: ~8' X, I aO "Ii.{ Square Feet, Height <br />..,. ;l. 'I Jt I~ <br />RESIDENTIAL: ATTACH (2) PLOT PLANS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORKS. <br />COMKERCIAL: ATTACH (3) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~illLDING <br /> <br />_ELEC"l"RICAL <br />V KECllAlfICAL <br /> <br />/ PLUtIB~NG <br /> <br />PERMITS REOUESTED <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />$ <br /> <br />AMP Service 1t~~rida P~ln. ~u'p~ - ~.R.E.C. <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />SPECIALTY <br /> <br />_Fraae _Steel IYlllnrlltc.-f ul'of.J Other <br />Ho", Ib <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />/ <br /> <br />ROOFING <br /> <br />TYPE OF CONSTRUCTION: <br /> <br />_Block <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br />COMPANY .6:1Tted,.e (j ~/ I.e.- I1tJlYl<eS <br />State Cert. or Regist. , ~ <br />City License Registration' -.IF- ?A <br />********** ******************************* <br />:::::z ' J COllPAlIY 7ro,..J "1'\ G' / e.d "," <br />~ '0/ C ~ ~ State Gert. or Regist. . <br />-~ - _Jd() - L.., .................~~~~.~~~::::.::~~:~~:~~= . <br /> <br />~~ COMPANY rv e. {S of1 ~J1IYllh1. <br />State Cert. or Regist. If <br />Signature City License Registration . <br />~~ ****************************************** <br /> <br />KECRANTr. _ COMPANY 81} A r G,.,.. s <br />, State Cert. or Regist. t <br />Signatur 'ty License Registration' <br />***********~****************************** <br /> <br />BUTT .DER <br /> <br /> <br />Signature <br /> <br />#/70 <br /> <br />PLUMBER <br /> <br />#-~7tf <br /> <br />v- If( c <br /> <br />*-/7 <br /> <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />