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<br />APPLICATION FOR-PERNIT <br />CITY OF ZEPIIYRllILLS <br />BUILDING DEPARTHENT <br /> <br />, " <br /> <br />OWNER <br /> <br />oS U /If S ;-; / Ai c= ' C:;=AL..70 j2 LI <br />~BS2 q 5TH ~lf"'V~NV€- <br />If 6 ;<./!2- I pc) H v' 0 ~ A I /f./ 6/\/ <br />JOB LOCATION '3 B S'2 q <br /> <br />/,uc-. <br /> <br />APPLICANT <br /> <br />PHONE <br /> <br />?B8r 98'3/ <br /> <br />ADDRESS <br /> <br />~, <br /> <br />s- 7/-1 <br /> <br />LEGAL DESCRIPTION: LOT(S~ _ I/)- II BLOCK/ -~?SUBDIVISION <br />PARCEL I.D.~~ jl - ?-6 - 2/ - 0010, - / 5200 ~ 0 (00 <br /> <br />AV6 . <br /> <br />LOT SIZE <br /> <br />x <br /> <br />AREA SQ. FT. <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 />____Commercial <br /> <br />_Indust, <br /> <br />____Swim., Pool <br /> <br />..____l'I!H <br /> <br />IlpL~lI'acl+, Other <br /> <br />Revwt~lo v'\ <br /> <br />PROPOSED USE: ____Single Family <br /> <br />~M/F <br /> <br />____~~ of 'Units <br /> <br />____Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.** <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FOR1-1S.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />Ef,RMTTS REOUESTED <br /> <br />_ELECTRICAL <br /> <br />$ <br />300 <br /> <br />valuation of Total Construction <br /> <br />____BUILDING <br /> <br />AMP Service' <br /> <br />K 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 '-:"-Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />~ONTRACTOR 0ECTION <br />ml1LDER Company <br />State Cert. or Regist. 0 <br />Signature City License Registration U <br />***********.****************************** <br /> <br />EJ,EOTRT 01 A~ D.e vWl i 'J-rr;z. n~1 Company D~", "d '-;:z. VI o..Je-(, ;Z; //Ie <br />U" ~ - State Cert. or Re[Yist. ii c)c9t9--rJ?l?~ <br />Sirmatnre ~P/\o<~' City License Re[0:stration ii (, ry <br />,************************************** <br /> <br />****************************************** <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. n <br />City License Registration U <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. a <br />City License Registration 0 <br />****************************************** <br /> <br />MECHAN1CAl, <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist, U <br />City License Registration 0 <br /> <br />pTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />~..*.******~*.*..**.***.***********.'** <br />.' a " <'~1Yd) /'v-) . <br /> <br />PERNlT OFFICER. <br />