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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTKEHT <br /> <br />OWHER'S NAME ~/ ~ L1zA(JETJ1EPfC-Of/AI {'I!V!?rf! <br />OWNER'S ADDRESS 5' f5.r:;~5 /610 5/ <br />JOB ADDRESS 51'./VJ f d.~ /Y hI} v~ , <br /> <br />PHONE <br /> <br />,?y)- /;LO 7- <br /> <br />LEGAL DESCRIPTIOH: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' , (OBTAIH FROK PROPERTY TAX NOTICE) <br />WORK PROPOSED:_Hew Construction _Addition V Alteration ~epair _Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_KIF <br /> <br />_' of Units _K/H <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTIOH OF WORK: e /;.-y /}! -e 0 vt- A e 4' r /J t/ A-J /:J <br />r I ! <br />BUlLDIHG SIZE: X Square Feet, 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 COHSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />_BUlLDIHG <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />$ <br /> <br />AMP Service Florida Power Corp. <br />1 Lla.cl/~ <br />r ~{ 7 .;, Valuation of Mechanical Installation <br /> <br />W.R.E.C. <br /> <br />_ELECTRICAL <br />~GlWUCAL <br /> <br />_PL~IHG <br /> <br />GAS <br /> <br />ROOFIHG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIliISHED FLOOR ELEVATIOHS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZOHE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />COHTRACTOR SECTION <br /> <br />BlrrI.DER GOKPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />****************************************** <br /> <br />RI.RGTRICIAR ~COMPANY (!'~)l1-l-.e 1.?l~u"!r"'~L <br />s,~.:..~~ ~r.~\~~:';eO~:~:~~:~i:" . ({z7... <br /> <br />**** -********************************** <br /> <br />PLUKBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />~ <br /> <br />MECHANICAL <br /> <br /> <br />COHPANY (J'tJ a//4I/4/) ~,4 ( !!It e- <br />State Cert. or Regis t.' ;;; t~' 0 5" L( ? ? / <br />~L City License Registration' ~ '3 I <br />************~***************************** ~!' <br /> <br />Signature <br /> <br />OTIIRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />'''ION APPROVED BY <br /> <br />PERM.1T OFFICER. <br />