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<br />I I <br /> <br />APPLICATION FOR PEmaT <br />CITY OF ZEPHYRRILLS <br />BUILDING DEPARTMENT <br /> <br />DATE RECEIVED ~~ g' h s- <br />PLANS REVIEW FEE <br />(Y/~ q ~O <br />PHONE '16 - 2~W <br />~-r PIt~Co <br />SUBDIVISION J?JlOF:. (lft~ <br /> <br />OWNER'S NAME <br /> <br />10M ~ahr- <br />~ttl7 & !. 13L\fO. <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />PARCEL 10 # <br /> <br />WORK PROPSED: ONEW CONSTRUC ION <br /> <br />o ADDITION <br /> <br />o ALTERATION <br /> <br />o REPAIR <br /> <br />o INSTALL <br /> <br />~SIGN <br /> <br /> <br />o MOVE <br /> <br />o DEMOLI SH <br /> <br />PROPOSED USE: DSGL FAMILY <br />~OMMERCIAL <br /> <br />DMULTI-FAMILY <br />o INDUSTRIAL <br /> <br />0# OF UNITS <br />o SWIMMING POOL <br /> <br />o MOBILE HOME <br />o OTHER <br /> <br />& HEALTH DEPARTMENT APPROVAL <br /> <br />BUILDING SIZE <br /> <br />SQUARE FOOTAGE <br /> <br />N aN <br />~~,g <br /> <br />~TO~fUJ~ <br /> <br />DESCRIPTION OF <br /> <br />HEIGHT <br /> <br />RESIDENTIAL: <br />COMMERCIAL: <br /> <br />I <br />ATTACH (2) PLot <br />ATTACH (3) SET <br />PROPERTY SURVE <br />I <br /> <br /> <br />$ t'3(;O.~ <br />~ AMP <br />I <br />, <br />, <br /> <br />PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />SlGtJ <br />o ~Yn.J;lInG <br /> <br />PERMITS REQUESTED <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL <br /> <br />SERVICE <br /> <br />o <br /> <br />FLORIDA POWER <br /> <br />o <br /> <br />W.R.E.C. <br /> <br />o PLUMBING <br /> <br />o MECHANICAL <br /> <br />$ <br /> <br />o SPECIAL~Y <br />I <br />TYPE OF CONSTRUCTION: 0 BLOc1 <br /> <br />FINISHED FLOOR ELEVATIONS --l <br /> <br />VALUATION OF MECHANCIAL INSTALLATION <br /> <br />o GAS <br /> <br />o ROOFING <br /> <br />o OTHER <br /> <br />o FRAME <br /> <br />o STEEL <br /> <br />o OTHER <br /> <br />IS PROJECT IN FLOOD ZONE AREAO YES <br /> <br />o NO <br /> <br /> <br />, :,:,:,:,:,:,:.;.:.'';.',::,:.'.'.:.:. <br />~ '::~~'~f:iJ::~:~~i:i:i:!:1:f:~:;:n:~:~;i:;i;:;:~;~':': - :':';'H+;';';';';';';'!'~:;;L:~1T.~i:Fn~:r:j:i;fj~:;:;':;i:i;1';:h:l:i:~:~~:~~::':':' <br />:~lEFn:r~;:i~~:i:l:~:i:E!:~:~:!~i:i~i:j~:i~ ;':';';.;+;-i+i';'!';~';'; ......... ..... .... ..... <br /> <br />COMPANyArfLe t:;lGN~'NN '~G-- <br />STATE CERT OR REGIST fL- A fiR 12- <br />CITY PROCESSING L-1 ';1..5 <br /> <br />****************************************************************** <br /> <br />ELECTRICIAN <br /> <br />SIGNATURE <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />****************************************************************** <br /> <br />PLUMBER <br /> <br />COMPANY <br />STATE CERT OR REGIST # <br />CITY PROCESSING # <br /> <br />SIGNATURE <br /> <br />SIGNATURE <br /> <br />**********~*****~************************************************* <br />I COMPANY <br />I STATE CERT OR REGIST # <br />. CITY PROCESSING # <br /> <br />MECHANICAL <br /> <br />*************** ************************************************* <br /> <br />OTHER COMPANY <br />STATE CERT OR REGIST # <br />SIGNATURE CITY PROCESSING # <br /> <br />*************** ******************************************~****** <br />I <br /> <br />\ <br />