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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE (/":Yf'/.,t..>- /flc::-:,') I;~ /1", ;~,) /}S,-:'Oc, <br />/ <br />OWRER'S ADDRESS (It. /S- /3/(u ~c ," D/t-'t./ <br /> <br />f'l /:,1', tI / (,1 <br />JOB ADDRESS f::. ~ _ 'j <; 3/- ~/t:;), 'j - Y 5-- >7 - 'li>~, I ~' <br /> <br />PHONE <br /> <br />7 :? Y- DfN) 7 <br /> <br />Z e t';j,~ y J.: /~ . , ,.:~ ,~ ~ ') - y / <br />, / I <br /> <br />{f /0'> f {J,..} /J/II..r, <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL 1.D.' <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction --'ddition -^lteration --.X..;aepair _Install <br /> <br />_Sign <br /> <br />--...JIove <br /> <br />_Deaolish <br /> <br />PROPOSED~E: _S~eF_i~ <br /> <br />---XJt/ F <br /> <br />-!:L. of Units _M/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />-Restaurant [( Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />7'0 " <br /> <br />;fe:' (J /-1 c: t <br />f <br /> <br />~ ~ ,'/'V, /'4'- <br />/ <br /> <br />1'1'(1;: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />,~- ^ O() <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDERTIAL: <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 />~UILDING <br />_ELECTRICAL <br /> <br />j' <br />$ S'-/ 3~; ,-' <br /> <br />Valuation of Total Construction <br /> <br />AItP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-"ECIIAlIlCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS X. ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />F1IIIISIIED 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 />BIJU.Dm <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />F.T.RCTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />SiimAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />IlECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />**************************************** <br />.~ <br />/' <br /> <br />Signature <br /> <br /> <br />OTIIF.R <br /> <br />COMPANY %~<-Jf/lj liotfiA.'} (0. <br />State Cert. or Regist. #' 1ft' 00 ..{ ~- <;-) ~ <br />City License Registration' ,~ >1 0 <br />****************************************** <br /> <br />Signature <br /> <br />PERMIT OFFICER. <br />