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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAKE <br /> <br />~~~ Lo~ <br />, 1 ,\4- ~ r <br /> <br />PHONE ; I ~ 2...- b c> l k:, <br />L ( l-l-lllJ (~ "1 J 5'\.{ 0 <br /> <br />OWNER' S ADDRESS ,( 0 S- <br />J- fNfV.- <br /> <br />JOB ADDRESS <br /> <br />rb <br /> <br />BWCK <br /> <br />SUBDIVISION <br /> <br />LEGAL DESCRIPl'ION: WT(S) <br /> <br />PARCEL LD.' .:2. -J..~~ '\ ~~ \~ - O()OtJ\) -o5'c. t> <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition LA1.teration --Repair _Install <br /> _Sign -.JIove _DeJIOlish <br />PROPOSED USE: -LSingle Faaily _M/F _, of Units _M/H <br /> _ec:-ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />~ \v.....~ <br /> <br />~cO (' () tf'4L C'f lh ~ f2L L\ ~.4L (lwF <br />Square Feet. ;).l, J Height <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATl'ACH (2) PWT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ATl'ACH (3) SETS OF BUILDING PI.t\NS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ l\'\.\ 2..--- <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 />_MECllAlUCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />F1' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />BIITT.DER <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY Q-e.-~ ~ -L-..J <br />State Cert. or Regist. , -S CL G ~c..L DS3--('1l( <br />City License Registration' '71 <br />****************************************** <br /> <br />Signature _____ C-- C ~~ l pa TI~ <br /> <br />F.T.RCTRICIAN COMPANY <br />State Cert. or Regist. # <br />SignAture City License Registration # <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration f <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration # <br />****************************************** <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration # <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />