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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE <br /> <br />w (!,. / J) C- fG/-/- ~/C' <br />57 2~ !tp fC-. sr <br />S' ;ft{~. <br /> <br />PHONE <br /> <br />7%,3 ~qeJO <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1.Do' (1:< ~ ~ tJ6Ie; tJ<(;((j D 0 (78 (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ~tall <br /> <br />____Sign <br /> <br />____Kove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____KIF <br /> <br />____, of Units _K/H <br /> <br />____CoBBercial <br /> <br />_Indust. <br /> <br />_Swim 0 Pool _Other <br /> <br />____Restaurant & llealth Department Approval <br /> <br />DESCRIPTION OF WORK: 70 rPtJS 771--Lc.- <br /> <br />10 V(~ <br /> <br />~~M-B <br /> <br />S If-;g,. b <br /> <br />BUILDING SIZE: <br /> <br />? 0 X I(r. , <br /> <br />(<:0<) Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKSo <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTIONo <br /> <br />PERMITS REOUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />17t.f3 . r70 <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corpo <br /> <br />W.R.E.Co <br /> <br />---1fECHAHlCAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUKBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS:' <br /> <br />FT 0 <br /> <br />IS PROJECT IN FLOOD ZONE AREAl <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BUlI.DER <br /> <br />CONTRACTOR SECTION <br /> <br />/./--------~::::> COMPANY S~/KJ.~rJH_z;' <br />~.. State ~ert. or Registo , <br />,_ ~=- City L1cense Registration , <br />.......................................... <br /> <br />/!C{) If l,u 1/ 1-/ rkc:. <br />7tJ <br /> <br />Signature <br /> <br />ELECTRICIAN COMPANY <br />State Certo or Regist. . <br />SiDnAture City License Registration . <br />.......................................... <br /> <br />PLUKBER COMPANY <br />State Certo or Registo t <br />Signature City License Registration . <br />.......................................... <br /> <br />MECHANICAL COMPANY <br />State Cert. or Registo . <br />Signature City License Registration , <br />..................................*....*.. <br /> <br />OTHER COMPANY <br />State Certo or Registo t <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />