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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE <br /> <br />~ ~ Goss <br /> <br />OWNER'S ADDRESS -.5 ~J ~ <br />JOB ADDRESS --r;t-e. LAlit, <br /> <br />PHONE <br /> <br />7~J - (1;).. 7? <br /> <br />~ <br />v'lllJje <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 _Alteration _Repair _Install <br /> ~ _Hove _DeJIOlish ~~~~ <br />PROPOSED USE: _Single FaallY _H/F _' of Units _H/H <br /> _<=<-ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant Ii Health Departaent Approval <br /> <br />DESCRIPTION OF 1llIlU(: 1(ff \ AC f.1!) 0\ -{ .. -9 fr\ II b .. Ie. tk ~~ <br />BUILDING SIZE: lOx 35 ~ 3S0 Square Feet, Height <br /> <br />RESIDENTIAL: <br />COMKERCIAL : <br /> <br />ATTACH (2) PLOT PLANS Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~UILDING <br />/' ELECTRICAL <br /> <br />PERKITS REOUESTED <br /> <br />$ ~).; 00 Valuation of Total Construction <br /> <br /> <br />(pO AMP Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---?CBANICAL <br />LPLUKBING <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIliISBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />'IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />RITTI.Dg <br /> <br /> <br />.. CORTRA=::ZT.t.-t;~(d fU:k I!eM~ <br /> <br />/ /7 State Cer.. or Regi... . $ <br />~~- City License Registration' _____ <br />******* ******************************** <br /> <br />COKPANY ~ rd 1\'1 ~ I e.. c. <br /> <br />State Cert. or Regist. , ':l~ <br />City License Registration , { __ <br />* **************************************** <br /> <br />Signature <br /> <br /> <br />COKPANY e <br />State Cert. or Regist. , <br />City License Registration . <br />****************************************** <br /> <br /> <br />CO <br /> <br /> <br />rt. or Regist. . <br />City License Reg <br />**********~****************************** <br /> <br />COKPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />