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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTKENT <br /> <br />JOB ADDRESS <br /> <br />G },.., Te-r <br />sT <br /> <br />S''/ <br /> <br />PHONE(6'/3) 7/5 '-/7..09 <br />:2eph)lr-h( ))r 1" FL f3" 51.{ I <br /> <br />OWNER'S NAME ,$/ C)1t:J..e.! D. <br /> <br />OWNER'S ADDRESS 5335 L/ ~ <br />5335 47'J, <br /> <br />CI" <br /> <br />/', <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction _Addition _Alteration ~epair ~Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_DeJIOlish <br /> <br />PROPOSED USE: ~Single Faaily <br /> <br />_M/F <br /> <br />_' of Units _M/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: :E?f7A /1 c At:{; ~ Lt' " k n. rr c e.. (~O'" + y~ <"Yi ) <br /> <br />BUILDING SIZE: X Square Feet, Height <br /> <br />RESIDENTIAL : <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <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 />_MECHARICAL <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: _Block _Fraae _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 />Signature <br /> <br />~d~P~ <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />....******.**..***.*****************..*.** <br /> <br />BUILDER. <br /> <br />SiQflAture <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />....*...****.*..............*..***...*..*. <br /> <br />RT.RCTRICIAN <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration t <br />.*..*..................................... <br /> <br />PLUKBER. <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />.......................................... <br /> <br />OTHF.R COMPANY <br />~../ ~ ..., .k ",<.., State Cert. or Regist. , <br />Signature//~~~ City License Registration' <br />.......................................... <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />