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<br />APPLICATION FOR PERr-l'IT <br />CITY OF ZEPINIDlILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />~~~ <br /> <br />Q.,L~ ~ JP~ <br />\ 1.- ~.' <br />U')........'\.o.. .,,' <br /> <br />: ~.,,' <. <br /> <br />OWNER <br /> <br />"'!9;-\t:l..\ <br /> <br />__)l\~ ~\~~ D~' <br /> <br />JOB LOCATION S~\,,?-\ \ll)"^\::~...... <br /> <br />PHONE Z ~~ l. ? ~ If <br /> <br />'. <br /> <br />ADDRESS <br /> <br />~'iI. ' <br /> <br />LOT SIZE~ AREA SQ. FT. <br />V ~ ",\c... <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK.... <br /> <br />SUBDIVISION <br /> <br />U.l)-~'" <br />- <br /> <br />PARCEL I. D. ~~ <br /> <br />WORK PROPOSED:_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 />_~~ of Uni ts <br /> <br />,._H/H <br /> <br />_commercial <br /> <br />_Indust, <br /> <br />_swim.. Pool <br /> <br />Other <br /> <br />_Restaurant & Health Department Approval <br />BUILDING SIZE: t IJ X 1,..6 , / C, 8 ..__Square Fee t, <br /> <br />, ,tI <br />I Y\ 3 \0\ f,.. <br /> <br />. . <br /> <br />-')S4 It <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SET": OF BUILDING PLANS & (1) SKi' ENERGY FORM-S.** <br />ATTACH (3) SETS OF BUILDING pLANS & (1) SET ENERGY FORHS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />'~ BUILDING <br /> <br />V',RMITs... REOUESTED <br />\ <br />~"7 <) t) fi- Valuation of Total construction <br /> <br />$ <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 />Valuatlon of Mechanical Installation <br /> <br />.... <br /> <br />GAS ROOFING <br /> <br />C(PII\.(,.",.c,.lt<. ~,,".. <br />~ Block _Frame _Steel <br /> <br />SPECIAI,TY <br /> <br />. <br />_PLUMBING <br /> <br />'.... <br /> <br />S~Y' ~~W\ Other <br />~B a .v, <br /> <br />TYPE OF CONSTRUCTION: <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT, ~r-"': ~ 0.... <br /> <br />\ ~y. ~) <br /> <br />(f.)~ p, :Jll:f J <br /> <br />****************************************** <br /> <br />~ONTRALL~ ~ECTI0N <br />Company <br />State Cert. or Regist. a <br />C:Lty License Registration jf <br />******************~*********************** <br /> <br />JWILDER <br /> <br />Signature <br /> <br />Sir7fiature <br /> <br />Corroany <br />Scate Ce=t. or Regist. a, <br />City License Registration a <br />****************************************** <br /> <br />= <br /> <br />f,T.ECTRTCTAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 6 <br />City License Registration 0 <br />****************************************** <br /> <br />. ~.\TMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. a <br />City License Registration 0 <br />****************~************************* <br /> <br />j:1ECHAN1CA1. <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. a <br />city License Registration a <br /> <br />DTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />*"J;.~~..** **'*~**. *.*~**><*{k)~*.**' d:-:d:" ;::,:*"*,,,!: <br />, ~. fi}:' "- X. ,-, / , .' <br />, /Ij ~, -- <br /> <br /> <br />PERNIT OFFICER. <br /> <br />...........t' MIP' <br /> <br />"' ,~r.'~ <br />