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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />V .Q~ <br />~ ..,' <br />(T7~ ~~7 _~v <br />~~~ ~:> <br />7'n .~)V7 <br />PHONE <br /> <br />4 <br /> <br />'. <br /> <br />OWNER'S NAKE <br /> <br />KoO&eT <br />39 b 3 0 <br />~T 7 <br /> <br />G4ff11f! <br />CthhJ ct.! ,(.i> <br />~e I-Ifr- ~ <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />F6 1/fJ-r- <br /> <br />(?~Ag /:I <br /> <br />t:J~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />aq. db c2- / 60 ~ 0 () 7) ) a() <br />WORK PROPOSED:_New Construction ~ddition ~teration <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />_Repair _Install <br /> <br />PROPOSED USE: <br /> <br />_Sign <br /> <br /> <br />~ngle <br /> <br />_Move <br /> <br />_DeJIOlish <br /> <br />Fallily <br /> <br />_M/F <br /> <br />_' of Units <br /> <br />_M/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant &: Health Departllent Approval <br />DESCRIPTION OF WORK: !.2ff;YO .oeG<""; 6"112-- Slfw d.l 102,//'8 6uss j;~()1-( <br />BUILDING SIZE: 1c2.. X 1:3 D, :3 b () Square Feet. 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 />fO J ;). EO <br />, <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'l'RICAL <br /> <br />AMP Service <br /> <br />Florida. Power Corp. <br /> <br />W.R.E.C. <br /> <br />---1IECllANICAL <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 _Fralle _Steel <br /> <br />Other <br /> <br />FlBISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />RT.RCTRICIAN <br /> <br />CONTRACTOR SECTION ~ <br /> <br />~ ~ ~AIfr 5"'OAJS~ /!L-(jH/-r}vll <br /> <br />-' -- State Cert. or Regist. . <br />Signat~" / .. City License Registration f 70 <br />--~=_.. ....... *** ******* ***...... ....................**....**..* ...... *..*..* <br /> <br />~ <br /> <br />BIITI.DER <br /> <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />..****..**..******..********..*****..*..***..*..*** <br /> <br />:z-z.~ <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration , <br />*......***..............**......***..*..****..********..*** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration . <br />****************************************** <br /> <br />OTIIRR COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration f <br />***********************..****************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />