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<br />. ; <br />APPLICATION FOR PERMIT <br />CITY OFZEPHYIDIILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />N\\L.. ~ Cl'l~S'"m.\K'\\bN\ \t..lC' .' <br />\ 11 ~ Q'N'I '3'D\' \.1.~Rfu ~E. (Jr'1 YL 3352~IONE ,~rAJC;'{l7' ~041 <br />E.lD\~f.. 'RD\~N (~\()"r"iAa \,>\d~a \\k.btt\) <br />c;(olS ("Ibo..\ I ~L\11'\' 7~i.\HLLS LOT SIZE X AREA SQ. FT. <br /> <br />ADDRESS <br /> <br />OWNER <br /> <br />JOB LOCATION <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. ~~ <br /> <br />\\ ~ ?J,.,. 2.\ .' DD \D' DS~OO. . Dh/ C <br /> <br />WORK PROPOSED:_New Construction~ddition _Alteration '><:Repair _Install <br /> <br />_Sign/Temp. <br /> <br />_Sign <br /> <br />__Nove <br /> <br />_Demolish <br /> <br />PROPOSED USE: _Single Family <br /> <br />.~M/F <br /> <br />_;.._j~ of Units <br /> <br />._~I/1l <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: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />Cor-U-IERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR!'lS. ** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />;PERMITS REQUESTED <br /> <br />V BUILDING )RooAt.lG,$ 997.118 <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 />_PLUMBHl'G <br /> <br />.... <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block ____Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT, <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert. or Regist. 0 <br />City License Registration ~: <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Sip-nature <br /> <br />Company <br />State Cert. or Regist. U <br />City License Registration 0 <br />****************************************** <br /> <br />EI.ECTRTCTAN <br /> <br />Company <br />State Cert. or.Regist. 0 <br />City License Registration U <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />NECHANICAI. Company <br />State Cert. or Regist. 0 <br />Signature . City License Regis tration Ii <br /> <br />~~~ ~~A ~ It1Jr...........:::::::W<~:~:**;:~~lf')f,n\ ~~ <br /> <br />State Cert. or Regist. Ii c.. (,\{)l:;57t~ <br />Signature City License Registration Ii 31 <br />) <br /> <br />~;.~*** <br />APPLICATION APPROVED BYl ~. <br />.j <br /> <br /> <br />/' <br /> <br />PER!'lIT OFFICER. <br /> <br />""- <br />