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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRHILLS <br />BUILDING DEPARTMEHT <br /> <br />OWNER'S NAME <br /> <br />C-rf/6L <br />3}?~.3? <br /> <br />.') <br />15 .1k"~f <br />/1//;OM / <br /> <br />PHOHE <br /> <br />;7//-c?C:;3;( <br /> <br />OWNER'S ADDRESS <br /> <br />/71/6 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL I.D.' (j;?- db - ;;'/-()(J;;<(J-aJ500- {)ot..fl <br /> <br />SUBDIVISION <br /> <br />(OBTAIH FROM PROPERTY TAX HOTICE) <br /> <br />WORK PROPOSED:_Hew Construction _Addition --..Alteration ~epair _Install <br /> <br />_Sign <br /> <br />~ove <br /> <br />_DeIIOlish <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 <br /> <br />_Other <br /> <br />'I <br /> <br />.(. <br /> <br />DESCRIPTIOH OF WORK: <br /> <br />_Restaurant & Health Departaent Approval <br />MKuoP {5F &5!{X;A/cE <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square!Feet, <br /> <br />Height <br /> <br />RESIDEHTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUlLDIHG PLANS & (1) SET EHERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL HEW CONSTRUCTIOH. <br /> <br />_BUlLDIHG <br /> <br />$ <br /> <br />PERKITS REOUESTED <br />03 10(),.. ~ Valuation of Total Construction <br />. . 1 <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 />_PLUttBIHG GAS . ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUGTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDlISBED FLOOR ELEVAnOHS: <br /> <br />Fr. <br /> <br />IS PROJECT IH FLOOD ZOHE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />RIJTI.DER <br /> <br /> <br />COHTRACTOR SECTIOH <br /> <br />GOKPAHY l- j~HAP6te 2(]()F' AJ (; <br />, State Cert. or Regist. . <br />City License Registration . <br />~,~ ***************************************- <br />fUr 'kt:; K OJ H <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br /> <br />Signature <br /> <br />RI.RGTRIGIAII <br /> <br />Sian,.ture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />KEGBARICAL <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. t <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATIOH APPROVED BY <br /> <br />PERKIT OFFICER. <br />