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<br />APPLI.CATI0N FOR PEmlIT <br />CITY OF ZEPIlYIDnLLS <br />BUILDING DEPARTHENT <br /> <br />APPLICANT ,-1 E ~ f\J M I Us:;.. ~ <br />... ~ .-1;',.' .:~ ;. <br />ADDRESS .5' J t..i I ~ Ii ST') 'Z.t= P .J..f y:# )/1 1/.... / t::- / <br /> <br />PHONE (~'J 3)'7 R :z. - f 1'10 <br /> <br />'. <br /> <br />OWNER <br /> <br />,SAM ~ <br /> <br />JOB LOCATION <br /> <br />dAMF- <br /> <br />LOT SIZE <br /> <br />x <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.~~ <br /> <br />WORK PROPOSED:____New Construction --:.-Addition -LAlteration _Repair _Install <br /> ____Sign/Temp. _Sign _Hove ____Demolish <br />PROPOSED USE: ~Single Family ..:-J1/ F -~~ of Units ,._M/H <br /> _Commercial _Indust, _Swim. , Pool Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORl'1S. ** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />ff.RMTTS 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 />_H.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <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 />~ONTRACTOR ~ECTION <br />Company <br />State Cert. or RCf,ist. iF ..c:.If ~//;?J' <br />City License Registration a <br />****************************************** <br /> <br />nUTT,DER <br /> <br />Signature <br /> <br />El.ECTRTCTAN ./-ht/bA'ew P,;?/P-;-'?"' Company AA/7)v ?/P.4TT <br />State Cert. or Regist. II <br />SiDnature City License Registration a <br />****************************************** <br /> <br />F-IFcTRIL. <br />#.-..:2 <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. a <br />City License Registration II <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert, or Regist. a <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAl. <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist, a <br />City License Registration iF <br /> <br />pTHER <br /> <br />APPLICATION APPROVED BY ~~~:~:;;:~**********'" <br /> <br />PEronT OFFICER. <br />