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<br />APQKA'tAftolOt'oIEMftIT <br />CITY OF ZEPHYRlIlLLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME ~h?/I> ~ e/t.-6c:.-;1/ CI24e:-"i--- <br /> <br />PHONE 7Fo - ~-<.3Z. <br /> <br />OWNER'S ADDRESS 3Cf/9 ~&L-;?L!If/Te.- DR. <br />, <br /> <br />-J::t ~-I <br /> <br />,........... <br />ZC;;>/Y y.e#/Uf -/"b/ <br />, <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROH PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ~epair ____Install <br /> <br />____Sign <br /> <br />____Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____' of Units ____M/H <br /> <br />____Co..ercial <br /> <br />____Indust. <br /> <br />____Swim. Pool ___Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />Restaur.ant & Health Depar.tment Approval <br /> <br />1t~1 <br /> <br />e-.X / u <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <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 />PERMITS REOUESTED <br /> <br />/BUILDING <br /> <br />$ I tl tJ 0 . f.T'2) <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />____MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />____PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Bloclt ____Fra.e ____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 COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration' <br />........................................ <br /> <br /> <br />ELECTRICIAN COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration . <br />..*...*...............*..........*..*..*.. <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.........................................* <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration . <br />...........*.......**......**.......**.*** <br /> <br />OTHF.R COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration # <br />*....................*.........*.*....***. <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />