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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />q~v;L f~rl <br /> <br />OWNER'S NAME lIiJ.-J'h'\l6 Ita,.) ~A_ ,J.::. <br />OWNER'S ADDRESS 7 3 ~<1 64 Lt. B/l/cf <br />7 .3 i.( 'I C~ ~I.., ~, v J <br /> <br />PHONE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ----Alteration --.-Repair _Install <br />~ Sign _Move _Deaolish <br /> <br />PROP9SED USE: _Single Faaily <br />~eo..ercia1 <br /> <br />--.Jf.1 F <br /> <br />_' of Units _M/H <br /> <br />_Indust. <br /> <br />_Swim. Pool _Other <br /> <br />_Restaurant &: Health Departlllent Approval ~ <br />DESCRIPTION OP WORK: Er<ec:.t-751Zf ,'<IE. ~tON ) 6~d' w.tJH~'c~}io )(.-:3 <br /> <br />BUILDING SIZB: 55 7x .s&:' Square Feet, I ~eight <br /> <br />RESIDENTIAL : <br />COMMERCIAL : <br /> <br />ATTACH (2) .JI,.OT PLANS &: (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATTACH (3Y'SETS OP BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />/" BUILDING $ <br />- t€1.ts-t",.:IlC <br />L-ELECI'lUCAL <br /> <br />~ <br />2. 3 SO Valuation of Total Construction <br /> <br />PERMITS REOUESTED <br /> <br />AMP Service Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <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 _Fr8lle _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />PT. <br /> <br />IS PROJECT IN FLOOD ZONB AREA? <br /> <br />Signature <br /> <br /> <br />(~:%1b" <br /> <br />CONTRACTOR SECTION ~4f q q 0 <br /> <br />./7 ~ COMPANY 0Es--7' C-E.,...., 'T~,f) ~ SIC...) 5 <br />~ State Gert. or Regist.' ~ 5"0""06 ~:1. _ <br />City License Registration , / '7 _'::J <br />............................. <br /> <br />.......................................... <br /> <br />BUILDER <br /> <br />RI.RCTRICIAR ~ <br />Silmature <br /> <br />COMPANY r-JE.S7 C~,..ff~L S/~ <br />State Cert. or Regist. # .s- 6 dr::'Oc::J <br />City License Registration # <br />.......................................... <br /> <br /> <br />f-t'-;/ <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration f <br />.......................................... <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration t <br />.......................................... <br /> <br />OTHF.R COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration t <br />.......................................... <br /> <br />APPLICATION ,APPROVED BY PERKIT OFFICER. <br />