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<br />.. ~ <br /> <br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />~ / .,,-. . <br />OWNER'S NAME JtJ..V) I-OSblU"J <br />OWNER'S ADDRESS hl):l7 {!,res.-bAi <br />JOB ADDRESS 1,(),;J7 (!re~J.l <br /> <br />PHONE rf;V. 7i'l- 75"1-~ <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL 1.D.' LJ3-d&-~/-I;{)/~-II:;<<'>-tJO~1 (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction ~ddition ----Alteration _Repair VInstall <br /> <br />_Sign <br /> <br />~ove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: ~ingle Faaily <br /> <br />_M/F <br /> <br />_' of Units _M/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant {( Health Departaent Approval <br />DESCRIPTION OF WORK: NeoJ HIJII ~ 5ys ten) /N5W/ed <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 />PERKITS 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 />----1fECBANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Insta11ation <br /> <br />_PLUKBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF GONSTRUGTION: _Block _Fraae _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 />COMPANY <br />State Cert. or Regist. . <br />City License Registration t <br />****************************************** <br /> <br />BIITIJ)ER <br /> <br />Signature <br /> <br />ELECTRICIAN COMPANY!ftc:,{MIJ u/}fV1/U L Fud7f/~A-L ccJN'T/?k 1'tf~ <br /> <br />/! /) /' ().. /J State Cert. or Regist. , <br />SimlAtur~/Lk~ GL~. City License Registration' Co 7;;2... <br />****************************************** <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />PLUMBER <br /> <br />MECHANICAL COMPANYAeihr's ;+OPITNe Gns f 1J;f F~ . <br />~ J /" // State Cert. or Regist. f <br />Signature P./ ~ ---<....... City License Registration' /7 <br />~ ********~A&.*************************** . <br /> <br />OTHF.R COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration # <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />