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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILLS <br />BUILDING DEPARTMENT <br /> <br /> <br />" i / /' _~ _ <br />L-<!- () c,(./ <br />~/-t <br /> <br />OWNER'S NAME ~LL< 0... D~,~ ,~h ie, <br />OWNER'S ADDRESS fJ 1+ f'k f f{;.J.I 7 }/" t-/. r <br />JOB ADDRESS e, 10'1 Sl tV'e-'"t. C> ".t<(S VIL ' <br /> <br />PHONE loo'3 7G.S- ;13C;f <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />PARCEL I.D.' 03- 2..t;,';2 /- IJ/~O 'VOOcJo- /!2..:57) (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:~New Construction ____Addition ____Alteration ____Repair ____Install <br /> <br />____Sign <br /> <br />_Move <br /> <br />____Deaolish <br /> <br />PROPOSED USE: ____Single Faaily <br /> <br />____KIF <br /> <br />____' of Units ____K/H <br />~Swia. Pool _Other <br /> <br />____eo..ercial <br /> <br />____Indus t. <br /> <br />____Restaurant & Health Department Approval <br />DESCRIPTION OF WORK: 'PG vi... Q""" J S ~ "'f::y:oJ.0 <br />. <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COKKERCIAL ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />r-;;UILDING <br />~CTRICAL <br /> <br />PERKITS REOUESTED <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. 011 <br />rJ~:}-.,rJ <br /> <br />----"ECllAlUCAL <br />AUMB~rm <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br /> <br />YES NO <br /> <br />TYPE OF CONSTRUCTION: _Block ____Fraae ____Steel <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE <br /> <br />****************************************** <br /> <br />PLUMBER <br /> <br />CONTRACTOR SEC'7lN <br /> <br />COMPANY orn -e Ju'-</N Pocj~ ~ <.. <br />/J State Cert. or Regist.' c.A:::. 0 eJ... 5' 5'" Y ~ ~ <br />~ City License Registration' 09:''1 ~ vM'r <br />****************************************** ' I .~~ ~~~ <br /> <br />~' COIIPANY -. .. !-~ <br /> <br />::.~~ A -L___ ~~~. L~~ O;.:~:~~:~i:'" ~ <br /> <br />· ~. ........................................ifo~ <br /> <br />COMPANY ;I 0Yw.{ ~ p~ L <br /> <br />State Cert. or Regist. . <br />City License Registration t ? / // <br />......******.****************************. (I ~ <br /> <br />BUILDER <br /> <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. t <br />Signature City License Registration . <br />***********~****************************** <br /> <br />OTRF.R COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration # <br />****************************************** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />