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<br />()o <br />APPLICATION FOR PERMIT ~~ ') / r <br />CITY OF ZEPHYRBILLS Cf>'6~ /l7K r -. oV..Jt "'7 <br />BUILDING DEPARTMENT rf/ . r J \ I ~ /1 ~ <br />5 . I'd-- <br /> <br />OWNER'S NAME L\f'c..\L \~ S+00e...S \ ~ . PHONE ~\~- [pa\- 55~<3 <br /> <br />OWNER'S ADDRESS 5~J:; D ~ ('e..c...\::..e.v('\d\~ Pc-<-\(. Df'l \)<L J ~M.~ ,-t\ ~3tcJD <br /> <br />JOB ADDRESS l!/"J =~C ~ 0....\\ e:, 0 \.l\ ~U~ ~ Z:... <...{)" "\ y" h \ \ \<) ) ~ I 0 ll\ d 0.. <br />~~-S- <br />LEGAL DESCRIPTION: LOT(S) I ~ - I S BLOCK d" SUBDIVISION -:c LP).,'1f'k.I/J s . <br />1'\ - ~ 4 "\ <br />PARCEL 1.D.' J I. .;}l. -al -00 I b -oC>~co - 0/10 ",,' (OBTAIN FROH PROPERTY TAX NOTICE) <br />l ) - a I. - 3-\ - 00 ll> .. <) 6 ~ CO - t::> 1 G\ 6 <br />WORK PROPOSED:_New Construction _Addition --Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Deaolish <br /> <br />pmPOSED~E: _Si~leF~i~ <br />~eo..ercial <br /> <br />_H/F _' of Units _H/H <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />I tVska...\\ <br />, <br />X )0 , <br /> <br />'So,\ <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />Vc:..~r <br /> <br />~~IO-v ~'.l ~ <br />\ <br /> <br />I <br />BUILDING SIZE: J D <br /> <br />100 <br /> <br />Square Feet, <br /> <br />~'l <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />....:::&..BUILDING <br />'/... ELECTRICAL <br />~CIWIlCAL <br />dLPLUMB~NG <br /> <br />/ g-J L7cX'. t!)::) <br /> <br />, ~ <br /> <br />/ao AMP Service <br /> <br />$ <br /> <br />$ <br /> <br />GAS <br /> <br />_Fraae _Steel <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />TYPE OF CONSTRUCTION: <br /> <br />_Block <br /> <br />FlBISBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />PERMITS REOUESTED <br /> <br />Valuation of Total Construction <br />~FIOrida Power Corp. <br /> <br />W.R.E.C. <br /> <br />Valuation of Mechanical Installation <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />R,.....J. ,(>..~ IO~ <br /> <br />Other <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTIO~ .:::::... <br />n- c. c:, ('0\.1 ? JZ.1"" \Co e.",:> . '\. <br />COMPANY ~f.R\~~\<..~ oL.. 6;d~1^.u...\~P. E4rec:J <br />State Cert. or Regist. t Pc. - c.o5~3 t.-- <br />City License Registration t ~ /).~...... J <br /> <br />..........::::..;C?~ JPc <br /> <br />State Cert. Regist. j V <br />City Lice Registration , B-...l s-n <br />******************************* <br /> <br /> <br />BmlJ>l!R /J !-e~j-/. <br />SignatureJ'~( -( J, <br /> <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />OTRRR <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration t <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />