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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />JOB ADDRESS <br /> <br />I <br /> <br />ullln r~~ <br />~ / IJ. ,-uce <br />C v II~ ,'\ ":;. <br /> <br />I <br /> <br />glJ )J'L~l <br />f1, (JOw". r <br />JrcJ..'1 \ <br /> <br />PHONE <br /> <br />'99(-)1({ <br /> <br />OWNER'S NAKE <br /> <br />OWNER'S ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />S, (,e r- 0<1- ~ ~ <br /> <br />PARCEL I. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PRoPOSED:LNew Construction _Addition ~teration _Repair _Install <br /> <br />_Sign <br /> <br />~ove <br /> <br />_DeIIOlish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_KIF <br /> <br />_' of Units _M/H <br />_Swill. Pool )-- Other <br /> <br />_eo.aercial <br /> <br />_Indust. <br /> <br />Restaurant & Health Departllent Approval <br />DESCRIPTION OF WORK: S;'p1 If\. ~ i~I S l; Sit V"f"".. <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />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 />$ /IO()~6D <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 />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />ROOFING <br /> <br />Y SPECIALTY <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />TYPE OF CORSTRUCTION: _Block _Frtllle _Steel <br /> <br />Other <br /> <br />FDiISHED FLOOR ELEVATIONS: <br /> <br />Fr. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />BUILDER <br /> <br />ELECTRICIAR <br /> <br />SiMlAture <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />COMPANY .....\........)0'" ,.ff' "lIe] <br />~~ I ~' State Cert. or Regist. ~ ? J) ~ lj k' <br />City License Registration f ~ / t <br />****************************************** <br /> <br />OTRRR <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />