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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />JOB ADDRESS <br /> <br />LOT - <br />OWNER'S NAKIL-J:: t1'\ -e r 1I I J <br />.~ ~ <.:..:::> ~ <br />~ A Vl'\ -e- <br />IS ~ <br /> <br />Pt:7i n;-'<..... G u(' ro. <br />AN\~+,^y st <br /> <br />PHONE <br /> <br />'f""") <t?-)(. .J..\ "f r <br /> <br />OWNER'S ADDRESS <br /> <br />Wdy <br />, <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROK PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction ~ddition -.Alteration ~epair _Install <br /> <br />_Sign <br /> <br />----.Kove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _S ingle Faraily <br /> <br />----.KI F <br /> <br />_, of Units _H/H <br /> <br />_Comaercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant 1& Health Department Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COHHERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS 1& (1) SET ENERGY FORMS. <br />. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />_BUILDING <br />~ELECTRICAL <br />---"ECHAIIlCAL <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />100 <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUKBING GAS 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 />BUILDER <br /> <br />COKPANY <br />State Cert. or Regist. t <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />::~:~~~ <br /> <br />. <br /> <br />COKPANY")( ~ a~ r C(ff <br />State Cert. or Regist. t l;:o-So~Oc~ 'i <br />City License Registration . ) & 7 <br />****************************************** <br /> <br />PLUKBER COKPARY <br />State Cert. or Regist. . <br />Signature City License Registration , <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration . <br />***********~****************************** <br /> <br />OTHER COKPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />