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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />GjJ'Cf7' <br />8'?- .' <br /> <br />JOB ADDRESS <br /> <br />~ '11 utE. -r. H /teSt? A./. <br />b Cf t ~ ,L/J()~ L lJt:b]) <br />s-'1f7f: ' <br /> <br />PHONE ;777. tJ63 '7' <br />} fZ z..kf, CLS. FC <br />:5 I LV ete- C> .fK5 <br /> <br />OWNER'S NAKE <br /> <br />OWNER' 5 ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />C) .3 JL~ J.--( Ol? () <br /> <br />BLOCK <br /> <br />SUBDIVISION <br />aD; A-- (OBTAIN FROK PROPERTY TAX NOTICE) <br /> <br />PARCEL 1. D. t <br /> <br />{)(j)Oo <br /> <br />WORK PROPOSED:_New Construction _Addition ---Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_KIF _' of Units ----1t/H <br /> <br />_ec:-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: % Po UI!- <br /> <br />13)t13 <br /> <br />5' LIIj1 ; <br />/" <br /> <br />13)t/3 C.(Jl7foS I~ 46P tL Sc..etiW /J;fJl( <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEHTL\L: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />COMKERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />199' < t5D <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'l'RICAL <br /> <br />ANP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----1IECIIAIIlCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIllISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJEcr IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />Signature <br /> <br />CONTRAcrOR SECTION <br /> <br />~-:...._.:: ..... .... COMPANY S/ thJ 3 7}tfr;e. <br />. ,"'- -- -~=-;//?f State Cert. or Regist. t <br />(-:".,-: ..... .. City License Registration t <br />-_.- ..' ****************************************** <br /> <br />Itwl'( /VJ'1. <br />70 <br /> <br />BIJIUlER <br /> <br />( <br /> <br />F.T JO:CTRICIAH <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />****************************************** <br /> <br />SilmAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration t <br />****************************************** <br /> <br />" <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />