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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />~ . IJ ~.,11'-c;( <br />! ~{J JtI- c;7- <br /> <br />c, <br /> <br />OWNER'S NAME II /V\ ,A J <br />OWNER'S ADDRESS 'Y7" ~ 7 <br />JOB ADDRESS '-:S J> I tJ P- <br /> <br />F~ It t)-J ~ It-C h . l )::::. PHONE <br />( / <br />C.3 a -I ~ I? (I :z /~. '/ Ir , r / <br />, <br /> <br />Th If' I-< ..3 ~/~ tJ /S" -;-It IYu e. <br /> <br />7 f> ,.)- S ..5.- tJ b <br />.s~S-.y / <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL l.D.' /1-)6 -- t:3 / - d tJ I 0 - 6) I~ d ~ - &.J...[~D (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ~teration _Repair _Install <br /> _Sign _Move _Deaolish <br />PROPOSED USE: _Single Faaily _KIF _' of Units _K/H <br /> /ec:-ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />r N Ie if I \ t! Ie. <br /> <br />N e 0"l t! elc> I, 'J..-l C1 <br />./ <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 />$ <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 Kechanical Installation <br /> <br />_PLUKBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <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 />Signature <br /> <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY Jd h N L, i:' ,,~ ,\ <br />~ tate Cert. or Regist.' /:S ..k /,,:$ ~ <br />City License Registration . <br />****************************************** <br /> <br />COMPANY M:r~ -t- C1tL~ Zke--f- <br />State Cert. or Regist. . <br />City License Registration I ,/~~ <br />********************************* <br /> <br /> <br />v..f'~ ~ <br /> <br />RITII.DER <br /> <br />v <br /> <br />Signature <br /> <br />COMPANY (! { ( 1.3 <br />~..,)? &.L-. State Cert. or Ilegist, . <br />., City License Registration # <br />****************************************** <br /> <br /> <br />PLUKBER <br /> <br />Signature <br /> <br />AlA- <br /> <br />, <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration . <br />****************************************** <br /> <br />MECHANICAL <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration f <br />******.*********************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />