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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S N~O.~ S~. '"} iC~ 01 / e 1/1.0<. I" $ f- <br />OWNER'S ADDRESS ~ 01 (p. / ~ -;/-f !..S'/ <br /> <br />PHONE <br /> <br />?8'R - /J>~ ~ <br /> <br />JOB ADDRESS <br /> <br />Sa ~ <:.- <br /> <br />2 -h/, /.(, ~~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:____New Construction ----Addition ----Alteration ____Repair ____Install <br /> <br />____Sign <br /> <br />--.Hove <br /> <br />____Deaolish <br /> <br />PROPOSED USE: ____S ingle Family <br /> <br />--.H/F _, of Units --.H/H <br /> <br />_eo..ercial <br /> <br />_Indust. ____Swim. Pool _Other <br /> <br />~estaurant & Health Department Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />e IJOftJ+ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMTTS REOUESTED <br /> <br />,4:...BUlLDING <br />_ELECTRICAL <br /> <br />$ <br /> <br />2 f2 '-/ -<: co <br />i <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KECHAHlCAL <br /> <br />$ <br /> <br />Valuation 'of Hechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ----Block. ,_Frue _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVAttONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />*********,******************************** <br /> <br />Silmature <br /> <br />PLUMB~ <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />Signature <br /> <br />l!IIIIlII ~ COIIPANY 4:/?l~~ d~ <br /> <br />. "" . / /, State Cert.or Regist. # ,f'e "1'1 ~/~ 'YR <br />Signature . City License Registration # 2'/0:;/ <br />~~...................................... - <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />