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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRHILLS <br />BUILDING DEPARTMENT <br /> <br />1 tf751~ <br />~ <br /> <br />LOT - <br />OWNER'S NAKE----'=- rn 't": r t'A l c:;( <br />OWNER'S ADDRESS ~ ~ <Ou ~ <br />~ A vY\ -e... <br />LEGAL DESCRIPTION: LOT(S) (0 ~ I f.c, 8" <br /> <br />Pe>i n -t-<... C t::lr ro. <br />t1 rnoe. +- '^ Y st' <br /> <br />PHONE <br /> <br />1'1 R-S(' .J...I' "t r <br /> <br />Welt' <br />( <br /> <br />JOB ADDRESS <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~ew Construction ----^ddition ~teration ~epair _Install <br /> <br />_Sign <br /> <br />----1Iove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />----111 F <br /> <br />_' of Units ----1I/H <br /> <br />_CoIaercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: 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 />~ELEC'1"lUCAL <br />----1IECllAHICAL ,$ <br /> <br />100 <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUcnON: _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 />BUILDER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />=CIAR~~~ 'COMPANY"I...~ ~refLZ; <br />State Cert. or Regist. . ~S't:J(poe>61/ <br />re x. J~ City License Registration' J€7 <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. , <br />Signature City License Registration . <br />...........~........................***... <br /> <br />OTHER COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration # <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />