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<br />APPLICATION FOR PERKlT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />@ <br /> <br />OWNER'S NAKE <br /> <br />6cxf.. " (--all ~ <br />llSD h~\t Bhd) <br />1 \4L\ 1\.\\1 lCWl tl <br /> <br />PHONE <br /> <br />'7gZ. P\~ <br /> <br />OWNER t S ADDRESS <br /> <br />7 '~H\\~ , fL ~354-1 <br />. <br /> <br />J)'f\\i{2' ",",'\\ \~ <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' (OBTAIN FROM PROPERTY TAX NOTICE) <br />Roe .,f2vcf' <br />WORK PROPOSED:____New Construction ____Addition ~teration ~Repair ____Install <br /> <br />____Sign <br /> <br />--"ove <br /> <br />____Deaolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />____M/F <br /> <br />____, of Units ____M/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_SwiJR. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: ~\J \~ \~ RQ' ~()uf () ~ "'1,.:) <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 />$~1. U\) <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 />____HECHAlfICAL <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 ____Fralle _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />....*.*.*************.*********.*.******** <br /> <br />CONTRACTOR SECTION <br /> <br />BUIIJ)ER <br /> <br />Signature <br /> <br />COMPANY <br />State ~ert. or Regist. f <br />City License Registration . <br />***************************.************** <br /> <br />ELECTRICIAN <br /> <br />SianAture <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration , <br />****************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration f <br />******..*.*******.*.*****.**.***.********* <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State ~ert. or Regist. # <br />City License Registration , <br />*******.********************************** <br /> <br />Signature <br /> <br />Signature <br /> <br />~ - COIfPANY IJ'J, I jj~>, {/M<:!rJ ,/II v'l, I /~ < <br />i ~. State Cert. or Regist.' t, QiJ5SLI'<; <br />. City License Registration # 21.5 <br />******.*.******************..**.********** <br /> <br />OTRRR <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />