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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRHILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAKE l1:lA 1~.s 71 c ['J /l-K S' <br />(j <br /> <br />PHONE <br /> <br />OWNER'S ADDRESS <br />JOB ADDRESS :375J 111/H€L. ,) Irt-Lc,l ~I b~ FL-Y3s-1// <br /> <br />LEGAL DESCRIPTION: LOT(S) '-1:15./ )l-~r~c4lLOCK SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition .--Alteration _Repair _Install <br /> <br />_Sign <br /> <br />~ove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />_M/F <br /> <br />_' of Units _M/H <br /> <br />_<=<-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTIOR OF WORK: <br /> <br />BUILDIRG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <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 REOUESTED <br /> <br />_BUILDIRG <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_ELECTRICAL <br /> <br />AMP Serv'ice <br /> <br />~CBAlUCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBIRG <br /> <br />GAS <br /> <br />ROOFIRG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTIOR: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FIRISBED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTIOR <br /> <br />RIJTUlER <br /> <br />Signature <br /> <br />COMPARY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />=:~."'. '. COMPARY~(hA/l.fJ CIl.-/fA/cflf-tL URC-Tj(JC <br />/ :Lc ,.. ~ State Cert. or Regist. . <br />',. ~ City License Registration . /1 ?d-.. <br />****************************************** <br /> <br />PLUMBER <br /> <br />COMPARY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />,. <br /> <br />MEGBARICAL <br /> <br />COMPARY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br />OTIIRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />