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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S _ /Ie 2/ l {o! (Yo! d PHONE <br />OWNER'S ADDRESS '3 9 '3) /J .1, /} /} Lv /14 j, 2 e,/Y h 7 ' h, l ( 5- <br />JOB ADDRMS lrf-lr 1.~ ),.., LA> d/J (} Ve... <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br /> <br />; /Cj~-J//;}- <br /> <br />. <br /> <br />r [, ~r/II 'vt.>o ,,(j <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <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 Departaent Approval <br /> <br />DESCRIPTION OF WORK: <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 />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ J., '100 <br />I <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />v'MECIIARlCAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ 7-,'100 <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 _FrUle _Steel <br /> <br />Other <br /> <br />FDlISHED FLOOR ELEVATIONS: <br /> <br />F1' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration f <br />.......................................... <br /> <br />RIITI.DER <br /> <br />Signature <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />.......................................... <br /> <br />ELECTlUCIAR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />MECHANICAL <br />Signature .;::; <br /> <br /> <br />COMPANY ''cO <br />State Cert. or Regist. f <br />City License Registration . <br />......................................**** <br /> <br /> <br />)/)"'} <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.*..*..*....***.*.*.....*.**.***********.. <br /> <br />APPLICATION APPROVED BY PERM.IT OFFICER. <br />