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<br />APPLICAnON FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAttE <br /> <br />5TZ (/ /" a. /?? c"..--v.....v <br /> <br />PHONE ) 7? 8' tSc) 9' <br /> <br />OWNER'S ADDRESS .3 9 ;?6lf' ~o.t?c> ~ o~./J Loc.>p <br /> <br />JOB ADDRESS .5 /"9-/?7e <br /> <br />LEGAL DESCRIP'l'ION: LOT(S) <br /> <br />c!Zo <br /> <br />BLOCK <br /> <br />SDBDIVISION /1'Je~tS'-oe;)'p r.$ 7~ /'1"'" 5' <br /> <br />PARCEL LD.' / 3c;l6-.;2/- O/~o- 0000 D - c>aoo <br /> <br />(OBTAIN FROH PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition -.Alteration _Repair ~Install <br /> <br />_Sign <br /> <br />--1Iove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: iSingle Faaily <br /> <br />_H/F <br /> <br />_' of Units _H/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 />~/,; Vetc v <br />, <br /> <br />/60 r"eer <br />X , <br /> <br />P"e ~c ~ <br /> <br />BUILDING SIZE: <br /> <br />6 rr <br />Square Feet. Height <br /> <br />RESIDERTIAL : <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />-BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-1IECllAlllCAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />-PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUcnON: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDlISHED FLOOR ELEVATIONS: <br /> <br />PT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />X <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />aUWlBR ~ <br />Signature c:::-... --- <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />.......................................... <br /> <br />F.T .RCTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />SiQDAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <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 />