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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />'180' <br />,,'{OJ <br /> <br />OWNER' S NAKE <br /> <br />;';~/L CC~/~(/I- ~Z>'"c:.s7/c.. O/1~PHONE <br /> <br />OWNER · S ADDRESS <br />L.vJ'2-15 <br /> <br />JOB ADDRESS <br /> <br />#11"9 :::H -> t;,~ <br /> <br />. Ocra~.i) <br /> <br />.s lr/ /' LJI2/ ~. AM <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1.D.' '?.'f k2.. (..-')..,1 0" 00 - C/O/C CJ (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED: ~ew Construction _Addition. --Alteration _Repair _Install <br /> <br />_Sign <br /> <br />--1Iove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />~/F <br /> <br />_' of Units --1I/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: /1- X JJ . :79~ <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 />$ "'1.~ <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'l'RICAL <br /> <br />/aU- AtIP Service <br />. <br /> <br />. Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--1IECIIAIIlCAL <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 />BUn.DER COKPANY Il~~~ ~,/p <br />~-zf./J State Cert. or egist.' <br />Signature 4J~ A ~ City License Registration . <br />. ....................................... <br /> <br /> <br />:~'::ur~CA- /J c/J n /11... COIIPANY fie "'" <br />~ ~~~___ State Cert. or Regist. . <br />City License Registration . <br />..............................*........... <br /> <br />y-p-- <br /> <br />/rJ <br /> <br />Signature <br /> <br />COMPANY /(1 ~ ~.ff~ <br />w.. t!IilJ State Cert. or aist.' <br />~~ City License Registration f Y fiY <br />... ..................*.............*.... <br /> <br />PLUMBER <br /> <br />MECHANICAL <br />Signature ~J3Jowv <br /> <br />COMPANY 4c e- <br />State Cert. or Regist. . <br />City License Registration f <br />.......**...........*...........**....*.*. <br /> <br />tf!::> <br /> <br />OTIIF.R COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration . <br />.......*........**..........*.*........... <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />