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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTKENT <br /> <br />OWNER t S NAKEto tel 11 R oJ. W4;lf eN <br /> <br />. <br /> <br />PHONE if 3- 779- (J 6-C/:L <br /> <br />OWNER'S ADDRESS "3 f? 7~1:, <br /> <br />1.7 D U.Jl )( re I'? 'f If d. <br /> <br />JOB ADDRESS <br /> <br />5..4NL F.: <br /> <br />LEGAL DESCRIPTION: LOT(S) $1 Cf <br /> <br />BLOCK <br /> <br />SUBDIVJJ3IO{}-UAi(;IO a/J; ~ '~ J <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />PARCEL 1.D.' ~ s:-. '7 s- ''J../~ ~ () /0 - I ~~ GOODd 0 <br /> <br />WORK PROPOSED:_New Construction t--Addition --Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Kove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: .t---Single Faaily <br /> <br />_KIF <br /> <br />_' of Units _K/H <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPrION OF 1IOIlK: ::~/-;';~t-~:tZ ~1A.. -~ fJ~ ~<~ <br /> <br />BUILDING SIZE: ~ { X ~, S re Feet, _ _ Height P if <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />...k-BUILDING <br /> <br />$ <br /> <br />'3o(Jo,cJ&" <br /> <br />Valuation of Total Construction <br /> <br />_ELEC'l'RICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----lIECHAIIICAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUMBING GAS So '/f:e. '- ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block ~Fr_e _Steel <br /> <br />Other <br /> <br />FIlIISBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />RITTI.DER <br /> <br />roNTRA=~D~~ <br /> <br />I J A . ~ -1-# State Cert. or Regist. . <br />Signature t/ ~ tt/~ City License Registration' <br />..........................~............ <br /> <br />RU:CTRICIAN COMPANY ~wnd.A /' <br />J/ /l t (.~ State Cert. or Regist. . <br />SilrnAture ~ ~ City License Registration' <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration t <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration . <br />****************************************** <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration f <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />