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<br />-i r <br /> <br />APPLICATION FOR PERKlT <br />CITY OF ZEPHYRHlLLS <br />BUILDIJG DEPARTqNT <br /> <br />~~6 t:;~i te>>;,~~. <br />::050 ~ti.. ~~~,41U> <br />7tJS/) Q./H<. ~1I{'fFl//I1!d/ <br /> <br />PHONE <br /> <br />f? a~. ;1:_. '::";~. <br />~~. ~' I <br />. O~o15~ <br />'. ~J~ <br /> <br />;_1 <br /> <br />OWNER'S NAKE <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ~teration _Repair _Install <br /> _Sign _Hove _Deaolish <br />PROPOSED USE: _Single Faaily _M/F _' of Units _M/H <br /> _ec-ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESGRIPl'ION OF WORK: "';;:;?E2/NZ. ~,;4/Pf//1.7/4,J.- ~.d..4t#A~c.~T<<:-/ <br /> <br />--'" <br /> <br />..c <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKlTS REOUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />/%t:/LJo. ~ <br /> <br />Valuation of Total Construction <br /> <br />_ELECl'RICAL <br /> <br />AItP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----"ECllARICAL <br /> <br />$ <br /> <br />Val.uation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVAITONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA'l <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />Signature <br /> <br /> <br />CONTRACTOR SECTION <br /> <br />mKPANY &t.c. ~.NJ".7~t~ ~ 6.. -Me. <br />State Cert. or Regist. . tf)..t78f~ <br />City License Registration . ~~9 <br />* **************************************** <br /> <br />/" <br />/' <br />v <br /> <br />RUII.DER <br /> <br />--,., <br /> <br />COMPANY ,4. ;P ~ h~~:.7R/C <br />State Cert. or Regist. . <br />~ , City License Registration' '~ <br />****************************************** I <br /> <br />I~' <br /> <br />Signature <br /> <br />~f lJJbd <br /> <br />COMPANY ~'E.e 4eljfAA//I'.A{'; <br />State Cert. or Regist. . t!...F G()-:z.. ~8 CoD <br />City License Registration . <br />****************************************** <br /> <br />~g3 <br /> <br />/ <br />v <br /> <br />PLUMBER <br /> <br />MECHANICAL /'1 <br />Signature I~#f'~ <br /> <br />, <br /> <br /> <br /> <br />COMPANY ~ <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />OTHRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration f <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />