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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />~ BUIU>IRG DEPARTIIBllT <br /> <br />0IillBR' S R .l 12 (h4 IZ ET tl 7(fJ W /.; IJ c:- <br />OWNER'S ADDRESS 3L/c;.s:- et:::~ Lj L L /9- )JG" <br /> <br />Of:F;'eE <br />PHONE i1!?o -~;;) 1/ <br /> <br />JOB ADDRESS <br /> <br />5./9 M ~ <br /> <br />LEGAL DESCRIPTION: LOT(S) BI.OCIL--SUBDIVISION <br />PARCEL" LD.' Zt/-,;?t, -d2./- '??ZJl)-dtJ/(/l}- ~ #t:,;. 0 (OBTAIN FROK PROPERTY TAX NOTICE) <br />WORK PROpOS~e;; Construction _Addition ----Alteration _Repair ~nstall <br /> <br />_Sign <br /> <br />---",ove <br /> <br />_Deaolish <br /> <br />PROMSEDUSE: _Si~leF~ily <br /> <br />---"'F <br /> <br />_' of Units _K/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swiat Pool _Other <br /> <br />Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK;-P ~ fJL &-~7 <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 SUR\iEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~UILDING <br />~ELECTRICAL <br />V MECHANICAL <br />~PLUHBING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIlUSHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br /> <br />CONTRACTOR SECTION <br /> <br />RUTT.DER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration' d;2.3 0 <br />.......................... <br /> <br />COMPANY /lCE' /:;t?~ f/i, <br />State Cert. or Regist. 66"'r~t:: / <br />City License Registration' /R~ <br />.......................................... <br /> <br />'-' <br />Signature <br /> <br />COMPANY <br />C\. I (~' State Cert. or Regist. . <br />~Y'( ..(...II City License Registration' c:l 0) 30 <br />................. ........................ <br /> <br />COMPANY /Jet:.- x.P~s.' <br />State Cert. or Regist. (' .JqrO,-=?9?56 <br />City License Registration . ~") <br />........................................ <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />OTRRR <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />.......................................... <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />