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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAKE <br /> <br />fA) (, I / I A-rv1 <br />, <br /> <br />W, <br /> <br />A~~~;) <br /> <br />PHONE <br /> <br />7 Sg - ()g-; ) <br /> <br />, <br /> <br />OWNER' S ADDRESS <br />JOB ADDRESS : 1 gr;;;.. 0 #/9 ~ I ~ <br /> <br />~~ -2 I 4, <br />( , <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:_Hew Construction --Addition ----^iteration ~epair _Install <br /> <br />_Sign <br /> <br />~ove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />~/F <br /> <br />_' of Units _K/D <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />_Other <br /> <br />'I <br /> <br />-.(, <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTIOH OF WORK: <br /> <br />BUlLDIHG SIZE: <br /> <br />x <br /> <br />Square 'Feet, <br /> <br />Height <br /> <br />RESIDEHTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLAHS & (2) SETS OF BUlLDIHG PLANS & (1) SET EHERGY FORMS. <br />ATTACH (3) SETS OF BUlLDIHG PLANS & (1) SET EHERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL HEW CONSTRUCTIOH. <br /> <br />f <br /> <br />~~LDIHG <br /> <br />$ <br /> <br />iqq~ <br /> <br />PERKITS REOUESTED <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--1IEGIIAIO.CAL <br /> <br />$ <br /> <br />Valuation of ttechanical Installation <br /> <br />_PLUKBING <br /> <br />GAS' <br /> <br />ROOFIHG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTIOH: _B1oclt _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IH FLOOD ZOHE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />RUTl.DER COMPANY <br />IrV~ t ~ State Cert. or Regist. · <br />Signature . ~4". 1" . U4L~ License Registration . <br />.............**......~.................. <br /> <br />RT.R.CTRTGIAN COMPANY <br />State Cert. or Regist. . <br />SignAture City License Registration . <br />.......................................... <br /> <br />PLUKBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................*.* <br /> <br />HECBANICAL COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration . <br />..*..............*.....*.....**.*....*.... <br /> <br />OTIIR.R COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration # <br />.............*.*.....**.........**..****.. <br /> <br />APPLICATIOH APPROVED BY PERKIT OFFICER. <br />