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<br />OWNER'S NAME <br /> <br />JOB ADDRESS <br /> <br />APPLICATION FOR PElUaT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />DATE RECEIVED <br />PLANS REVIEW FEE <br /> <br />, I <br />,: ~ i ....."J /I.l <br /> <br />/3,4 ..,L ~/'-' <br /> <br />PHONE <br /> <br />'3 '--/ of-I <br /> <br />L.. r / W <br /> <br />E MI/':c,r. /-1-1<.. <br /> <br />r' 1,0./ r <br /> <br />.IVl n- L-/-i- c. 4 I r,--e... <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL ID # <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICEl <br /> <br />D ADDITION <br /> <br />DALTERATION <br /> <br />DREPAIR <br /> <br />D INSTALL <br /> <br />WORK PROPSED: DNEW CONSTRUCTION <br /> <br />D SIGN <br /> <br />D DEMOLI SH <br /> <br />o MOVE <br /> <br />PROPOSED USE: DSGL FAMILY DWELLING <br />D COMMERCIAL <br /> <br />DMULTI-FAMILY <br />D INDUSTRIAL <br /> <br />D# OF UNITS <br />o SWIMMING POOL <br /> <br />D MOBILE HOME <br />D OTHER <br /> <br />o RESTAURANT & HEALTH DEPARTMENT APPROVAL <br />1'14/'-/< h"jc / <br /> <br />BUILDING SIZE <br /> <br />DESCRIPTION OF WORK <br /> <br />SQUARE FOOTAGE <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />D BUILDING <br /> <br />o ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />I "- )( '-/ c' <br /> <br />HEIGHT <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 REQUESTED <br /> <br />$ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o FLORIDA POWER <br /> <br />D W.R.E.C. <br /> <br />$ <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />D SPECIALTY <br /> <br />D OTHER <br /> <br />D GAS <br /> <br />D ROOFING <br /> <br />D OTHER <br /> <br />D FRAME <br /> <br />o STEEL <br /> <br />TYPE OF CONSTRUCTION: 0 BLOCK <br /> <br />IS PROJECT IN FLOOD ZONE AREAD YES <br /> <br />D NO <br /> <br />FINISHED FLOOR ELEVATIONS <br /> <br /> <br />BUILDER <br /> <br />SIGNATURE <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />PLUMBER. <br /> <br />SIGNATURE <br /> <br />MECHANICAL <br /> <br />SIGNATURE <br /> <br />OTHER <br /> <br />tJ ....;~-'W ~ tJ__./U;tkJ <br /> <br />COMPANY 15- <br />STATE CERT OR REGIST # <br />CITY PROCESSING # t./ q <br /> <br />****************************************************************** <br /> <br />-Ii ~. UJ ~tP;:;:;{-;J=~-'- <br /> <br />COMPANY /I€--<-- <br />STATE CERT OR REGIST # <br />CITY PROCESSING # / 'if? <br /> <br />****************************************************************** <br /> <br />fi;;tz;JW <br /> <br />v-J ~ ~7 <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />* * * * * * * * * * *,* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * <br />COMPANY 19 e....~ <br />STATE CERT OR REGIST # <br />CITY PROCESSING # (I ;; <br />, <br /> <br />~'-..'."......._- <br />--~.. <br /> <br />(y~' -- <br /> <br />***************************************************************** <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />***************************************************************** <br />