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<br />r~~~k <br />~ <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPHYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER' S NAME ~ h t..J q..-\) en l Y_ <br />OWNER' S ADDRESS (() I 0 S- I '1 +k. 5J <br />JOB ADDRESS S Prvv02-- <br /> <br />PHONE 7 g J- - (,o/fa <br />"2-~~€A:.. US FL s3L")C(I <br /> <br />LEGAL DESGRlP'l'ION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION ~ /i. I-l; LLS <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction _Addition ~teration _Repair _Install <br /> _Sign -'love _Deaolish <br />PROPOSED USE: ~Single Faaily _"'F _, of Units _M/H <br /> _ec-ercial _Indust. _Swia. Pool _Other <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: mW1lr~ '- ~ Vi t.Jyl <br />BUILDING SIZE: X , 0 ~_Square Feet. <br /> <br />'Om r(. $ -r- WI N'~cWS / ~)(~ sTl ~ <br />r Sc..f.ee.i) e.oo~ <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <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 />_MECHARlCAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br />TYPE OF CONSTRUCTION: -.:j....BIOCk _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FIlUSHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />BIJII.DER <br /> <br />****************************************:* ~O <br /> <br /> <br />CONTRAc:rOR SECTION CtJ...,A.. <br /> <br />YES NO <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />t ~5;;l-lt(3' <br />./ s5CJ 5 <br /> <br />Signature <br /> <br />Rl.RGTRIGIAII <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />SimlAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />omRR <br /> <br /> <br />COMPANY;J2fi-tlJv\.A- &'VA-ll..b ~~ ,~ <br />State Ce . or Regist.' Cc..c.....O ~~ <br />City License Registration. ~ <br />** **,'*-*******.... ..................... . N .~ ~ ,51'u-;JI; <br />" ' .' , RuC:f"II.....-e. .. . .(Jm <br />, . , .' , PERMIT OFFICER. w.p <br /> <br />" .~, <br /> <br />Signature <br /> <br />APPLICATION APPROf?ED 'aT. <br />