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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPllYRHILLS <br />BUILDING DEPARTMENT <br /> <br />.. <br /> <br />-:Sf ~~ S A Q~( <br />,.E:) (o;)A 9\O~e' C~. <br />JOB ADDRESS 5\,0;18 ~~r ~- ~~~Si g. <br /> <br />OWNER'S NAME <br /> <br />PHONE ~'3. 1jg3- 3(g~8 <br /> <br />OWNER'S ADDR&SS <br /> <br />3?JsLf 0 <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. t (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition. -.lUteration _Repair LInstall <br /> <br />_Sign <br /> <br />----'love <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_KIF <br /> <br />_, of Units ----'lIH <br /> <br />_~ercial <br /> <br />_Indust. <br /> <br />_Swill. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WO~: C.hOJn~QLCL ('tir ~dLA- 4~ LOo,L.fL <br /> <br />BUILDING SIZE: X Square Feet. Height <br /> <br />R&SIDENTIAL : <br />COMKERCIAL : <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 FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br />tGmCBAliICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />l.\Slo&~ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _FrUle _Steel <br /> <br />other <br /> <br />FDUSBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />'CONTRACTOR SECTION <br /> <br />BlITI.DER <br /> <br />COKPAHY <br />State Cert. or Regist. t <br />City License Registration t <br />.......................................... <br /> <br />Signature <br /> <br />Rl.RCTRICIAN <br /> <br />COKPANY <br />State Cert. or Regist. t <br />City License Registration t <br />.......................................... <br /> <br />SilmAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. t <br />City License Registration t <br />.......................................... <br /> <br />Signature <br /> <br />MECHANICAL COKPAHY . .' ,,' ..\..., <br />~ ~~ State Cen. or Regist. . <br />Signature /- I - . Y City License Registration t <br />'- ....................................... <br /> <br /> <br />OTRRR COKPANY <br />State Cert. or Regist. f <br />Signature City License Registration f <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />