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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />,/S'd- - 1,/63 <br /> <br />OWNER'S NAME !?1llff ~ k ,f, 1ft' I ~ ,.f-" ;( <br />OWNER'S ADDRESS '?~ J.2? f( ~ /(V/'.. <br /> <br />PHONE <br /> <br />JOB ADDRESS r il 2 c; <br /> <br />t;f/;~I: <br /> <br />2 - /./:/ Ie <br />2. - /"';//1", <br />BWCK f / <br /> <br />SUBDIVISION <br /> <br />LEGAL DESCRIPTION: WT(S) i'3 , ('f. IS <br />#' / <br /> <br />PARCEL 1. D. t <br /> <br />(OBTAIN FROH PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />-",ove <br /> <br />_DeIIOlish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_H/F <br /> <br />_, of Units -"'/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COMMERCIAL : <br /> <br />ATTACH (2) PWT 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 />--.t::BUILDING <br />~ELECTRICAL <br /> <br />PERMITS REOUESTED <br />$ SO(),O/'J Valuation of Total Construction <br /> <br />AMP Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHAIII.GAL <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 _FrtHIe _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <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 ~ w,ve~ <br />_/'J ,,/ State Cert. or Regist. t <br />7L!L..4 d >:Tot!'~ City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAN <br />Silmature .4 ~ ,;( <br /> <br />COMPANY 6(.dA/~/t' <br />~ ' State Cert. or Regist. t <br />-,,~ City License Registration' <br />****************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COHPANY <br />State Cert. or Regist. f <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />OTRF.R <br /> <br />COHPANY <br />State Cert. or Regist. # <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />