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<br />APPLICATION FOR PERMIT
<br />CITY OF ZEPHYRBILLS
<br />BUILDING DEPARTMENT
<br />
<br />DATE RECEIVED' ft,...?"'7 0 -tL.
<br />PLANS REVZEW rEI:
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<br />. ,', t."",':~'''' '\ '~.; .
<br />JOB :ADDRESS
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<br />O~N.~R'S, NAME 'l-C{ nd " fl.'! ,t) p:;t MY\tle n+5 T()( I
<br />
<br />PHONE !Jto 7- 7~9 ?
<br />
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<br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION
<br />PARPEL IDII .' -;3LI'" ~S- -, ? 1-()(X:JO-Ol>?/)O-cr:gO IOBTATN FROM PROPERTY TAX NOTICE)
<br />
<br />WORK PROPSEO: ~ CONSTRUCTION
<br />"<Of
<br />
<br />o AUOn'ION
<br />
<br />DALTERATION
<br />
<br />o REPAIR
<br />
<br />o INSTALL
<br />
<br />, ......
<br />
<br />DSIGN
<br />PROPOSED USE: OSGL FAMILY DWELLING
<br />
<br />o MOVE 0 DEMOLISH
<br />lltttiiLTI-FAMILY 0# OF UNITS
<br />
<br />,/ ,
<br />
<br />o COMMERCIAL
<br />
<br />o INDUS'I'RIAL
<br />
<br />o SWIMMING POOL
<br />
<br />o MOBILE HOME
<br />o OTHER
<br />
<br />,D RESTAURANT & HEAL'fn DEPAR'fMEN'f APPROVAL
<br />DESCRIPTION OF WORK Be, " t J Un,'-I- 1fP'J.. rfrtr..en+ B~
<br />BU~~D.ING SIZE ' :; Lj (-i/,,' Y 6C SQUARE FOOTAGE / -;),1 7 ~ .jf-; HEIGHT 0)/'
<br />
<br />RESIDENTIAL:
<br />COMMERCIAL:
<br />
<br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILUING PLANS & (1) SET ENER~Y FORMS.
<br />ATTACH (3) SETS OF BUILDING, PLANS & (1) SET ENERGY FORMS.
<br />PROPERTY SURVEY REQUIRED E'OR ALL NEW CONSTRUc:rION.
<br />
<br />'"
<br />
<br />~ILDING
<br />~LECTRICAL
<br />~LUMBING '
<br />~CJlANlCAL $
<br />o GAS, ~FING 0 SPECIALTY
<br />Ty~~t':~~':~~~~;RUCTION: ~OCK
<br />
<br />PERMITS REQUESTED
<br />
<br />$
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />~FLORIDA POWER
<br />
<br />o ,W.R.E.C.
<br />
<br />VALUA'l'ION OF MECIIJ\NCIAL INSTALLATION
<br />
<br />o O'fllER
<br />
<br />o FRAME
<br />
<br />o STEEL
<br />
<br />o O'fHER
<br />
<br />FINISHED,FLOOR ELEVATIONS
<br />
<br />IS PROJECT IN FLOOD ZONE AREAD YES ~
<br />
<br />
<br />BUILDJ:R
<br />
<br />.........***********************.******..*.*.********..***..**.***
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<br />SIGNATURE
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<br />COMPANY r, 'I.s + t lcos f: fed ~
<br />STATE CERT OR REGIST f# C:c:c> ~~"? 0
<br />CITY PROCESSING f# I 41.t'
<br />
<br />SIGNATURE
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<br />, ',' ~ ..~ (),-, ~ STATE CERT OR REGIST. ~~ 7'i '"
<br />- O----..A..r"'O cl::.. ~~~ CITY PROCESSING # J__
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<br />.*..**.****,********************.*******.****~*** I~ '-'
<br />C~PANY .~ ", rr
<br />STATE CERT OR REGIST # }"V ro 1..$0 ;J
<br />CITY PROCESSING # ..tt:;'jl so f2'1e:,' ~
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<br />PLUHBBI\
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<br />
<br />SIGNATURE
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<br />*****..**********.********************.*****************
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<br />COMPANY
<br />STATE CERT OR REGIST #
<br />CITY PROCESSING #
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