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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHlLLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAME <br /> <br />~~-H=' <br />3rg-Je2/ <br />S.;J'm(/ ~' <br /> <br />~ j?1o~ b~5 <br />fftt JIu e, <br /> <br />PHONE <br /> <br />OWNER' S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESGRlPTION: LOT(S) <br />PARCEL I. D. f <br /> <br />BI.OGIL--SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction ---.Addition ---.Alteration -.Jlepair _Install <br /> <br />_Sign <br /> <br />--.Kove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />--.KIF <br /> <br />_' of Units --.KIH <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant <br /> <br />DESCRIPTION OF WORK: <br /> <br />(j ~ e::/'~L Ser {I c.. e <br />t:;? IV rLW /1A' e. I >cl.B, e ~ <br />Square Feet, <br /> <br /> <br />i IUo IIG- <br /> <br />er t'tc'C-.f <br /> <br />BUILDING SIZE: X <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />A'lTACH (2) PLOT PLANS it (2) SETS OF BUILDING PLANS it (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS it (1) SET ENERGY FORKS. <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 />_ELEGTRlCAL <br /> <br />AtIP Service <br /> <br />Florida Power Gorp. <br /> <br />W.R.E.C. <br /> <br />--1IECIIAIflCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLutlBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDlISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJEC'l IN FLOOD ZONE AREA? <br /> <br />*****************..*........**...........* <br /> <br />YES NO <br /> <br />CONTRAC'lOR SECTION <br /> <br />BIJTI.DER <br /> <br />GOttPANY <br />State Cert. or Regist. , <br />City License Registration , <br />**************.......*****..************** <br /> <br />i~~ t? I2r~ <br />;!JI/rAiv a~,,~ JvUt - <br /> <br />Signature <br /> <br />R1.RGTRlClAR <br /> <br />COMPANY jYl#/+~w U~(L toe:- <br />State Cert. or Regist.' ~;;t !-,f.{t{'7 <br />City License Registration . ~~ <br />*****.****.**.***...****.*.**************. <br /> <br />SiOTulture <br /> <br />PLOMBER <br /> <br />GOttPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <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 f <br />*************.**************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />