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<br />JAN-21-98 04:51 PM <br /> <br />:313 '=':::;J.J 1 "355 <br /> <br />f>.ra'1 . <br /> <br />APPLICATION FOR PERKrT <br />CITY OP ZEPHYRUILLS <br />8UI1J>lNG DEPAR1l1ENT <br /> <br />OWHAA'S N~~ (C)~_ <br /> <br />:s 'l~ ;;l ~ 'J: _ () "'-Q <br />~q ~Yl e- _~ <br /> <br />LEGAL DESGRIPTlUN: LOT(S)__~ (( /~1 IlLOC,,"-- <br /> <br />OWNER'S AlJDRESS <br /> <br />PHONE <br /> <br />7 ~ &- 'J ( -y ~ <br /> <br />JOB ADDRESS <br /> <br />PARCEL 1.D.'_ <br /> <br />SUB!>l VISION_ <br /> <br />WORK PRoPOS eo '-,2(NO" cons troction __Addltioll --A.!'eratiOll --"oPBir _Install <br /> <br />(OBTAIN F~OH PROPERTY TAx NOTIG~l <br /> <br />_Sign <br /> <br />_Move <br /> <br />_UellOlish <br /> <br />PROPOSED USE: ~_Sin81e faa.ity <br /> <br />_H/p <br /> <br />-' oC Units --..Jt/ll <br /> <br />-C~(!rc.tal <br /> <br />_Indus t . <br /> <br />_Swi.. Pool _Other <br /> <br />DESCRIPTiON OF WORR:_ <br /> <br />_.Restaurant & Health DepartJlent Approval <br /> <br />BUILDING SiZE: __.-"-----_"_. <br /> <br />_Square Feet. <br /> <br />Height <br /> <br />RESIDEN1'!AL : <br />COHMERCIAL : <br /> <br />ATTACU (2) PLoT PlANs ,& (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMs. <br />ATTACH (3) SeTS OF 8UILDING PLANs & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED fOR ALL NEW CONSTRUCTIUN. <br /> <br />___BUILDING <br />JLF.LECTRI<.:AL <br />_PfEClfANlCAL <br /> <br />~~ITS REQUEsTEQ <br /> <br />$ <br /> <br />Valuation or Total Construction <br /> <br />I c., c: APlP Senr ice <br /> <br />Florida Po~er Corp. <br /> <br />__W.R.E.C. <br /> <br />$ <br /> <br />Valuation of HedulOical lnstallat ion <br /> <br />_PLlntBING <br /> <br />_GAS <br /> <br />.RooFiNG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRU<.iION: _Block __FeMe _Sleel <br /> <br />Other <br /> <br />FINISHED fLOoR ELEVATiONS: <br /> <br />n. <br /> <br />IS PROJE~. IN FLOOD ZONE AREA? <br /> <br />*....._*.........*.*.....*****...-...***** <br /> <br />YES NO <br /> <br />Signature <br /> <br />CONTRACTO~ ~E(;rlQli <br /> <br />COttPANY_ <br />State Cert. or Regist. # <br />City License Registration , <br />-.t.*.........****...._..********....***** <br /> <br />BUlU>RR <br /> <br />EI.F.CT&l;C]A~ " COMPANY tld- a..:/ r ~~ <br />~ /1' ~ /?/ ~ Slale Cert. or Regist. f e5<>q0<,,,,.., <br />Si_tu," rrJ~~. ~-,- City Lkenso Registration' ---111 <br />t****t*....t*..**...**...**.........*.t*.. <br /> <br />P1.lJHR~ <br /> <br />Signa lure <br /> <br />COMPANY <br />State Cert. or RegiSl, f <br />City License Registration , <br />t*t*..tt****....*.*.__.........._.,.*.*.*. <br /> <br />IlECHANlGAL <br /> <br />Signatur:e <br /> <br />COMPANY <br />State Cert. or :Regist. *. <br />City License Registration' <br />....*....**~**.*****.**....*.***...***.**. <br /> <br />muu <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Regist:cation f <br />.............**.......****....*.*......... <br /> <br />APPL!(;ATlON APPROVED BY <br /> <br />PERttIT OFFICER, <br />