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<br />APPLICATION FOR PERMIT <br />CITY OFZEPHYillIILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT Ift:.E /9}.. Lf fYl . <br />ADDRESS 3g~~5 p/JUVJ (;.Rj)i/6 PIl. 2-JJILL(' ,filJ. PHONE '7 J>d-:Jb/(, <br />OWNER J! Att..f)L./J j?1/)Ar~ S- <br />f . ' <br /> <br />JOB LOCATIONLDT":Q, ..?KIJ/? VdAJDJ}JS 1.../1,'2 -H)J.L~ HJt.LOT SIZE s:r' X !p' I\REA SQ. FT /OO~ <br />LEGAL DESCRIPTION, LOT(S)'SO -f!I;:. BLOCK :;'C SUBDIVISION ~ (,/7 ,,>-o.-</lf_J <br />PARCEL I. D. t~ 1/ /)0- /JtJ~tJO- tf).5Pc:> / Y - 02 6 - d / - <br />WORK PROPOSED: v/ New Construction '____Addition ----Alteration ____Repair ____Install <br /> <br />____sign/Temp. <br /> <br />____Sign <br /> <br />_Hove <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />_M/F <br /> <br />_t~ of Uni ts <br /> <br />_____H/ll <br /> <br />____Commercial <br /> <br />~Indust, <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACll (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />COl-fr1ERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR~IS. ,~-!: <br />**COPY OF CONTRACT REQUIRED, <br /> <br />V<UILDING <br /> <br />~F.RM1TS REOUESTED <br /> <br />$ 77:Jb. tJO <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />H.R.E.C. <br /> <br />____MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />____PLmm ntG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />____Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT, <br /> <br />****************************************** <br /> <br />Signature <br /> <br />f(fJ Y tJl)JVJ j5";..S ~ONTR~~~~~n~r>>21~L#PJ. <br /> <br />/J J-I) t! State Cert. or Eegist. if <br />~{j?----/ City License Ecr.istrat~on <br />****************************************** <br /> <br />C I? CO ..?~b ~t) <br />i'~ /6.0 <br />, <br /> <br />IHJ1LDER <br /> <br />Si!!n::\ture <br /> <br />Company <br />State Cert. or Eer.ist. a <br />City Liccnse Registration 0 <br />****************************************** <br /> <br />ET .F.CTR1 C1 AN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Rcgist. 0 <br />City License Registration 0 <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. a <br />City License Registration 0 <br />**********+*****************************~* <br /> <br />HECHAN1CAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Eegist. 0 <br />City License Registration ~~ <br /> <br />OTHER <br /> <br />*~~*******************~*****~~*~*~~~~~~~~~ <br />A P P [,I GA TI 0 N A PPROVED By:if a-~d 111 R~" ,'^ .. ... ................... P ER>1I T 0 FFl GER , <br />