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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRlIlLLS <br />BUILDING bEPARTKENT <br /> <br />'\ - 77 <br />IJ.--cr <br /> <br />OWNER'S NAttR <br /> <br />UDHJ.J ~f}WIJR..D~ <br />l..t) r- J b "'?J>.o.J;l L;;W-1AJDA <br />.s,4frJe <br /> <br />PHONE <br /> <br />'6/7-- .:J) LJ9 <br /> <br />OWNER. S ADDRESS <br /> <br />1... Q?P <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br />PARCEL I.D.' J'I-:Jl...;lJ-OJ/,o '-0QzzL 0/60 <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PRQPERTY TAX NOTICE) <br /> <br /> ..z --.Addition --.Alteration _Install <br />WORK PROPOSED:____New Construction _Repair <br /> ____Sign ---...Move ____De.olish <br />PROPOSED USE: --=:S'ingle F8IIily ---...MI F _' of Units _Kill <br /> _C~ercial _Indust. ____Swia . Pool _Other <br /> <br />-..Restaurant lie Health Department Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />CO^",C-R e.r6 - ...s;.I/LjJ - ...5L RIi:IE-/U ~""." /eLJO"':: <br /> <br />BUILDING SIZE: <br /> <br />Iv X 9 <br /> <br />S-o if Square Feet, 9 ;'O.PIH~ight <br /> <br />(/"" BUILDING <br />_ELEC'fRICAL <br /> <br />$ <br /> <br />.- <br />~ '-It.).DO Valuation of Total Construction <br /> <br />PERMITS REOUESTED <br /> <br /> <br />> <br />Cl <br />a::: <br />n. <br />0- <br /><1' <br />t- <br />o... <br />W <br />o <br />t!J <br />2: <br />.....0 <br />I-=:' <br /><C=:) <br />!::lc::: <br /> <br />RESIDENT1At.: <br />COHHERGlAL : <br /> <br />ATTAL,. (2) PLOT PLANS & (2) SETS OF BUILDING PLANS lie (1) SET <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPKRTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />AMP Service Florida Power Corp. <br /> <br />---...MEGIIAtrlCAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />--'pLUHBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block _Fr_e _Steel <br /> <br />Other <br /> <br />FIRISHBD FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS 'PROJECT IN FLOOD ZONE AREA? <br /> <br />*..*.***....*.*.....*....*.*.*.*..**.*.*.. <br /> <br />YES NO <br /> <br />BUIIJJER <br /> <br />CONTRACTOR SECTION <br /> <br />~. COIIPANY /7a /JLilm. <br />0' ~ ~ ~ State Cert. or Regist. , CR. CO";> '-/1. f'D <br />'/1;. ~ City LIcense RegIstration' ~ <br />*..*.*..*......*.**...*..*.***.*..**...*.* <br /> <br />Signature <br /> <br />EI.ECTRICIAR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />*.***.**.*.*..**.....*...*.***.*.....*.*.* <br /> <br />Sianature <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />....****..*.*..**.**.*...*.**.*..*....*... <br /> <br />Signature <br /> <br />KEClIANICAL <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.**.***.*****..**...**.*.**...*....****..* <br /> <br />Signature <br /> <br />OTHP.R <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />.*****...**.....*.*...**...*.*.*.*..*..... <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />