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<br />APPLICATION FOR PEIlIIIT t:J ~1 <br />CITY OF ZEPHYRBILLS \f(. ~:5'" <br />BUILDING DEPARTMENT } <br /> <br />~~ .. <br />c~a. . u ;)tJq <br />1~9>- ~, <br /> <br />OWNER'S NAME "'~I\IO l~ tJ.J I \60 r0 <br />OWNER'S ADDRESS 3 CJ ~3o Cin/lXl Y R.cL <br />JOB ADDRESS ,c::::o~ .e <br /> <br />PHONE <br /> <br />~~ ib...t <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. f <br /> <br />(OBTAIN FROK PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair V Install <br /> _Sign ---,"ove _Deaolish <br />PROPOSED USE: _Single Faaily _KIF _, of Units _K/H <br /> _eo..ercial _Indust. _Swia. Pool e Vother <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: ?-I/.~' &(. ..L\.p.. <br />BUILDING SIZE: \ "- X ~D .~Square Feet. 15 <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 />PERK1TS REOUESTED <br /> <br />_BUILDING <br /> <br />$ \Z,CXj() <br /> <br />Valuation of Total Construction <br /> <br />_ELECTIUGAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_HEGBAlfIGAL <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 />fl-v <br /> <br />Other <br /> <br />PDlISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJEGT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />BUn.DER COMPANY ~d CO~~ <br />~ ~ State Cert. or Hegist. . <br />Signature c.. City License Registration' <br />~. ............*****************.******~***** <br /> <br />~ ~ A ?1~ mKPANY/Jcp / t?erS <br />/JUc p A . r lJ(}){ ~~:~e L~~~~e O~e:~:~~:~ion . <br /> <br />. .**...*..***.*.*****.***...*.....*..*:j) <br /> <br />1 COMPANY [1/ cc:. t!1~d{ <br />"'1;'/ /):Q <br />: . /1.[/ A State Cert. or Regist. , <br />Signature' /t/....,-PC./ / ?~ City License Registration' <br />...............*.....***..**.......***.**. <br /> <br />roHPANY fb:: Kcv J;' iL - <br /> <br />State Cert. or Regist. <br />City License Registration f <br />.............*.*..*.........*...*..... <br /> <br />870l <br /> <br />/'R-? <br /> <br />PLUKQER. <br /> <br />~~/Id-. <br /> <br />v/ <br /> <br />lHEGHANlGAL <br />Signature <br /> <br /> <br />'1..5 <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration t <br />...............*....................*..... <br /> <br />APPLICATION APPROVED BY PERK1T OFFICER. <br />