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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER · S ADDRESS <br /> <br />a J. .iI 0. -' '-?h.u- Ie ~ (; Ice; r <br />? YO 5' ~ Je; (.1~,4 J. 0 oJ:? <br />'-"" e;;r v. , <br /> <br />.PHOJE <br />zj /I./k <br /> <br />OWNER · S NAKE <br /> <br />H ~.3SY/ <br /> <br />JOB ADDRESS <br /> <br />S Ct 11-1(/ <br /> <br />LEGAL DESCRIPTION: LOT(S) d~ [J BLOCK <br />PARCEL 1. D.' /1f- - dJ k - d. / 0) h 0 <br />WORK PROPOSED:~ew Construction -^ddition -^lteration <br /> <br />SUBDIVISION dh/~/ Cr/:>u( <br />bO <br />-tlCOOO- 0 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />_Repair _Install <br /> <br />_Sign <br /> <br />---1Iove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single FUlily <br /> <br />_M/F <br /> <br />/ <br />_' of Units ~M/B <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool ___Other <br /> <br />_Restaurant &: Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />:;) (, X 12. l:A ~1 Square Feet. Height <br /> <br />ATTACH 1!LPLOT PLANS &:~ETS 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 />BUILDING SIZE: <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />f <br />1L-BUILDING <br /> <br />lL-ELECTRlCAL <br /> <br />t/ MECHANICAL <br /> <br />LPLUHB~NG' <br /> <br />PERMITS REOUESTED <br />$ J h, zrv-o Valuation of Total Construction <br />- <br /> <br />AMP Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fralle _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 /> <br />~ COMPANY ~ <br />, ./ / .../1 / ~ State Cert. or Regist. . <br />Signature -~...c- ~~/fI City License Registration' <br />, . ....................................... <br /> <br /> <br />ELECTRICIAN ~_ / ,J/~< ':::.~:~r01~~C{eg~1.yt.~."J fh~ <br /> <br />Sianature ~/ft<<- /lJZt City License Registration . -/).', J a ?..~ <br />...... ........................................................ . <br /> <br />COMPANY S~~ (Iii adtc .~ ~q <br />State Cert. or Regist. . <br />City License Registration' ~~O <br />....*.........*..*..........*.........*** <br /> <br />IIIlCIIAIllGAL COHPAIlY &( #~ 54 ill It If c/ <br />cJ / J~- I State Cert. 0 Regist.' t <br />Signature petri/Uk ~ City License Registration' C).)...)~ <br />. *...................................... <br /> <br />r COMPANY <br />~ State Cert. or Regist. , <br />City License Registration # <br />........................................ <br /> <br />PLUMBER <br /> <br /> <br />/ <br /> <br />Signature <br /> <br />ornER <br />Signat~re ~"" <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />