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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER · S NAKE <br /> <br />f( UTH ,1<-11-1 ;vo <br />S~ / R /9r~ .5T <br />/ 9~ ST <br /> <br />PHONE <br /> <br />;?ff"- 3 J.3<"1 <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESSl//, ~~ I X-- <br />- <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL LD.t / I .2. Go L I 60 ) ~ <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />J ~ <f () OOtJ 80 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> _Sign _Move _De8lolish <br />PROP9SED USE: _Single F8IIily _M/F _' of Units _M/H <br /> _<=<-ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: ~--~. <br /> <br />fjk +IIFH/ <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 />~U>ING <br />~GTRICAL <br /> <br />PERMITS REOUESTED <br /> <br />~CllANICAL <br /> <br />$ v 21 7" <br />ISO <br />7-/7 D <br /> <br />Valuation of Total Construction <br /> <br />AMP Service ~rida Power Corp. <br /> <br />W.R.E.C. <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 />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BIITI.DER <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />ELECTRICIAR <br /> <br />COMPANY ~CJ(; ~ ';:;L fl-c..... . <br /> <br />.dr, t\.LL V' v>..aT State Cert. or Regist. , <br />'1'/ u.,- 'u q 4c-'1 City License Registration t <br />****************************************** <br /> <br />2c.~ <br /> <br />Sisma ture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />1IllCIIAIIIC6L ~ <br /> <br />Signature .; <br /> <br />~.. "_ COMPANY 5ov\li~tc.. <:a~+~ ~ <br />State Cert. or Regist. , <br />r 'T City License Registration' _ 2II'f ..s- '3 <br />****************************************** <br /> <br />OTHRR <br /> <br />APPLICATION.APPROVED BY <br /> <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration f <br />****************************** <br /> <br />Signature <br /> <br />PERMIT OFFICER. <br />