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<br />APPLICATION FOR PERKIT . ULc2 tJ ~ r <br />CITY OF ZEPHYRBILLS . it 0 L7) ~ q <br />BUILDING DEPARTIlENT ~jfQ-.1 & /' p - I G~f <br />~(;Gif J. Do1Al~l- 6i II [),WIIIS PHONE )50 I <br /> <br />OWNER'S <br /> <br />OWNER'S ADDRESS~ <br /> <br />JOB ADDRESS <br /> <br />3rrbO r <br /> <br />- <br /> <br />PrertVDNcl Rd. Zcfl.lutt~;113. PIA 33StfO <br /> <br />LEGAL DESGRIPl'ION: LOT(S) BLOCK SUBDIVISION <br /> <br />" <br /> <br />Q~~~L I. ~~ J ;$ S- - ~ 6-..:2..1 - DOlO - 06 [/OlJ-VtJ:lO (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK ~~~~SED: ~ Construction _Addition _Alteration' _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: ~le Family <br /> <br />_H/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 WO~: ~ ~ ~;" <br /> <br />BUILDING SIZE: <br /> <br />x ,47~O Square Feet, Height <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 />RESIDENTIAL : <br />COMMERCIAL : <br /> <br />~LDING <br />~CTRIGAL <br />vt;;GllARlGAL <br />~UHB~NG <br /> <br />PERMITS REOUESTED <br /> <br />$ <br /> <br />76,OCO, .0 <br /> <br />AtIP Service <br /> <br />Valuation of Total Construction <br /> <br />~, F.lorida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />Va.luation of tKdtelliea 1 ~tallation <br /> <br />GAS <br /> <br />ROOFING <br />-6aae _Steel <br /> <br />Other <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: <br /> <br />_B.lock <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />F'f . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? ~ <br />YES NO ~ <br /> <br />****************************************** <br /> <br />BIITI.Dm <br /> <br /> <br />rft6() ~ /90 (, CONTRACTOR SECTION <br /> <br />~ COMPANY <br />"ll State Cert. or Regist. f <br />City License Registration . <br />**************************************** <br /> <br />fltf>:J!{ (Juput <br /> <br />Signature V <br /> <br />RT.RGTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration f <br />************************************ <br /> <br />~ktlurul <br /> <br />Signature <br /> <br />v" <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration t <br />************************************* <br /> <br />~D~ <br /> <br />PLUMBER <br /> <br />KEGBANIGAL <br />Signature /' <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration f <br />************************************ <br /> <br />~(fuJIM< ())>>vt <br /> <br />OTHRR <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration # <br />************************************ <br /> <br />~ VdrlU/AJ <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER, <br />