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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />JOB ADDRESS <br /> <br />19~ ~h1:/h - <br />-5 9 it ?r4r?~..vef1- <br /> <br />CI> <br />.>--::< 5 -;; Cf S:I--, <br /> <br />PHONE <br /> <br />'7&0- 7~5-/ <br /> <br />OWNER · S NAME <br /> <br />OWNER' S ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROK PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction -"ddition -"Iteration _Repair _Install <br /> _Sign _Kove _Deaolish <br />PROPOSED USE: _Single F8Ilily _KIF _' of Units _K/H <br /> _ec:-ercial _wdust. _Swill. Pool _Other <br /> <br />_Restaurant &: Health Departaent Approval <br />DESCRIPTION OF WORK: ;;? ~ 7bv o/c Cfte--r ~ <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 />_ELECI'RlCAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KECIIABlCAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />****************************************** <br /> <br />lUJII.DER <br /> <br />Signature <br /> <br />OTRF.R COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration t <br />****************************************** <br /> <br /> <br />/" f"\ COMPANY ;;uejT' C~ ~5 <br />~_ ) State Cert. or Regist. . <br />City License Registration f <br />******************************** <br /> <br />Eke! <br /> <br />/C/~ <br />, r <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration f <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY ~ ,V C;~ <br />State Ceri. or Reg st. f: <br />City License Registration f <br />****************************************** <br /> <br />()O <;-11:z... <br />/ e 4.... <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />