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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />LOT <br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />~ me r" t"\. I d t.:J'::>1 " + e: C <..:..)( (0. <br />-:s '-, <.c:, {).J- A 'Y\ 'C' 1- h. Y ~ -r <br /><" <br />,)fT 111 <e.- <br />L' <br />I '-I.~ (J BLOCK <br /> <br />PHONE <br /> <br />17 g-,r- A/~",- <br /> <br />OWNER'S ADDRESS <br /> <br />~ c-.. v <br />I <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />SUBDIVISION <br /> <br />PARCEL 1.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:-4New Construction -----Addition -----Alteration ~epair _Install <br /> _Sign ---1Iove _Deaolish <br />PROPOSED USE: _Single Family ---111 F _, of Units ---1I/H <br /> _CoB.ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Depart-ent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />~ELECTRICAL <br /> <br />100 <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECllAlUCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUKBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FlRISBED FLOOR ELEVATIONS: <br /> <br />F1" . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />:=CIAR~~~ COMPANYi..~ ~ r- etJf <br />State Cert. or Regist. "f:.-.s 0 t:)Occ 'I <br />rex. J ~ City License Registration # J&7 <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration f <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration . <br />***********~****************************** <br /> <br />OTHER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />