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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />~ /1;_ <br />, . UU(J- <br />'v 5<5',9 <br /> <br />OWNER · S NAME <br /> <br />ihoma:s <br />(0(';) 3D <br />/'ot~ L-/~ <br /> <br />L e; +7~ke- <br /> <br />1? /'c13 e. Wet y :u \^1'1t~ <br />- z.e()hl/v R~3e <br />f t <br /> <br />PHONE <br /> <br />~/3 ~77?;;l-21/5Lj <br /> <br />OWNER · S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />M H- r-?<11-l <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL J.D.' 03-:J/~ -..J.l - '0/750 - COCOo - or:fo (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~w Construction _Addition _Alteration _Repair _Install <br /> <br /> _Sign _Hove _DeIIOlish <br />PROPOSED USE: ~ngle Family _H/F _, of Units _H/8 <br /> _C~ercial _Indust. _Swim. Pool _Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />_Restaurant & Health Deparbaent Approval <br /> <br />\5 hfC) / C4rfDrT <br />( ~l <br />L ( I <br />r X 1;2. ,/ tP?r Square Feet. <br /> <br />Height <br /> <br />BUILDING SIZE: <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />on <br />~OD~~ <br /> <br />PERMITS REOUESTED <br /> <br />~UlLDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Frame _Steel <br /> <br />Other <br /> <br />FDUSHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BUTI.nER COMPANY f)WI!J€-12- <br />~::::::---State Cert. or Regist. , <br />City License Registration , <br />* ********************************* <br />~ <br /> <br />ELECTRICIAN COMPANY <br />State Cert. or Regist. f <br />SiROature City License Registration , <br />****************************************** <br /> <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration . <br />****************************************** <br /> <br />KEGHANI~ COMPANY <br />State Cert. or Regist. * <br />Signature City License Registration , <br />****************************************** <br /> <br />OTRF.R COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration # <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />