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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER · S NAME <br /> <br />1 <br />{/ tLz'l .l <br />fp/dJ <br /> <br />t/ J~J/~ <br />itJ. '-t Ii' <br />{J:jl./UJ / j)T <br />~rj cUv~-t U <br /> <br />. <br /> <br />PHONE 1:7 2l gJ - ()..s- / "'I <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />1r?/u0 <br />, <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. t <br /> <br />(OBTAIN FROH PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition --...Alteration _Repair _Install <br /> <br />_Sign <br /> <br />--"ove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Si~leF~ily <br /> <br />_H/F <br /> <br />_' of Units _H/H <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />tll!,1 <br />BUILDING SIZE: X <br /> <br />_Restaurant & Health Depar~ent Approval <br /> <br />[{aI-i-\] ~ <br />11 I <br />:} , <br /> <br />Square Feet, <br /> <br />(/ "\ I J <br />() j 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 />PERHITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-.JtECllANICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fr~e _Steel <br /> <br />Other <br /> <br />FIlUSHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA 'I <br /> <br />*****.*.**........*.*......***...******..* <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />COMPANY <br />/1 (J. t/ A State Cert. or Regist. , <br />(y ~tGL ~. ! ,d~,J City License Registration t <br />**..****.**..**.**.*******..**.*********** <br /> <br />Signature <br /> <br />F.T.RCTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration t <br />***.************.******..***************** <br /> <br />SilmAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration t <br />***..**.****.****************.************ <br /> <br />Signature <br /> <br />KECBANlCAL <br /> <br />COMPANY <br />State Cert. or Regist. * <br />City License Registration t <br />*******.*************.******************** <br /> <br />Signature <br /> <br />OTRF.R <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />**.*****.**.********.********************* <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />