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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />9r ~ · . ~r ) <br />, L([ U ~ -9 Y <br />9-;;;~ <br /> <br />OWNER'S NAKE <br /> <br />0i { ~ qJC 0 PHONE <br />(l {;..~d -??1~ <br />5C( /XL <br /> <br />i?y2.. - 201? <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOGIL.-SDBDIVISION OQ Ie 5/04:.- <br />PARCEL 1. D.' 0 2 ~ 2 r; -- 2 1- 00 2. 0 - (Jo 700",,/)001 () (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:_New Construction _Addition --..Alteration _Repair ~Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_M/F <br /> <br />_' of Units _M/H <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Depar~ent Approval <br />DESCRIPTION OF WORK: ~ CA f ,f () r if 6) / / X dO" C;-) 3 1< .:2.0 <br />I <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />f.rJ) E><1.5 (. <br />! ~).)fg:s <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />_BUILDING <br /> <br />$ <br /> <br />. a (t- PERMITS REOUESTED <br />! C:(JrfI', c':---~aluation of Total Construction <br />/ <br /> <br />_ELEC'I'RICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---1IEGllANI.CAL <br /> <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 />FDUSBED FLOOR ELEVAnONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />BIITT.DER <br /> <br />~ <br /> <br />-X <br />YES NO ( <br />..............................................................................*** A it L f...,.- Z ,.. ~ 11- <br /> <br />. (:, :/9'1 <br />WNTRAgoR ~::' H I .~ '1f. <br />COMPANY ) > (j~,~1Jfrt <br />4- ~ State Cert. or Regist.' R XO'O JQ<''17 <br />City License Registration" 31 r <br />*..*.. *********..********..*..*****..****....*..*.. <br /> <br />Signature <br /> <br />RT.RGTRICIAR COMPANY <br />State Cert. or Regist. . <br />SianAture City License Registration . <br />****..************..***..*..**********....****** <br /> <br />PLUHBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />..*................*............*..................*....**..*..******.. <br /> <br />KEGllAHICAL COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration . <br />****************************************** <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration # <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />