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<br />OWNER'S NAME <br /> <br />~q;-e <br /> <br />APPLICATION FOR PERMIT C. .. T'lqi ~ j 14 -->~ <br />CITY OF ZEPHYRBILLS J!1t' - / dJ <br />BUILDING DEPAR _ ---/~ /-f' <br /> <br />A' Ce..\\'7,{1,5'1., 1 <br />//-p4 ~ ~PHONE} 7?Cf~/~/~? <br /> <br />cY~~ <br /> <br />OWNER'S ADDRESS '3 j?tJ L./ ~ <br />;7'<:7 #te <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL I.D.' 11-2(;.- 2-;-ocJ/O -I Z}'OC/-cJ/;? / (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:A:..New Construction _Addition _Alteration _Repair _Install <br /> _Sign _Move _Deaolish <br />PROPOSED USE: -4-Single Faaily _M/F _' of Units _M/B <br /> _~ercial _Indust. _Swia. Pool _Other <br /> <br />Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: d ',-(/Ie Cvc:c. V f- Car Pb ~I- <br />I' , <br />BUILDING SIZE: -S-x ))j, J iz. Square Feet, R'/ Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTAGB (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 />$ <br /> <br />:J t:.--/ ()O ~ <br /> <br />Valuation of Total Construction <br /> <br />_ELEGTRI.CAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MEGBAlllCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br />/jhPu'l v";t Other <br /> <br />TYPE OF CONSTRUCTION: _Block _Fralle _Steel <br /> <br />YES <br /> <br />~ <br /> <br />FIRlSBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />RUn.DER <br /> <br />'CONTRACTOR SECTION <br /> <br />COMPANY ~/..> /~/~~~~~ <br />~ '1' ~ State Cert. or Regist. . "" CJ <br />City License Registration . <br />*** ************************************ <br /> <br /> <br />Signature <br /> <br />RT.RCTRTGIAN <br /> <br />COMPANY <br />State Cert. or Regist. # <br />City License Registration . <br />****************************************** <br /> <br />SilmAture <br /> <br />PLUMBER. <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />OTRF.R <br /> <br />COMPANY <br />State Cert. or Regist. I <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />~ <br />I' <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />