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<br />APPLICATION FOR PERl-lIT <br />CITY OF ZEPIIYroIILLS <br />BUILDING DEPARniENT <br /> <br /> <br />APPL'ICANT DoL'^' II\.:-.f --r;:-:z..v\I2/fiJ <br />ADDRESS 3~ I~: U~YJJ~II"~1n Av~,'<2~~; lL5 <br /> <br />OWNER .1)~ V\ S V\.; J e If' <br />JOB LOCATION 3 q 3;2 0 ~<)D~ Ave.., , <br /> <br />PHONE <br /> <br />7f'Y <br /> <br />3??9 <br />, <br /> <br />" <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.~~ (I) (){)() - CC)qOO -(!)o J...b' <br /> <br />_Sign/Temp. <br /> <br />_Sign <br /> <br />_Alte~ationl _Repaij ~Install <br />C9U-t:s ,'0... (!) vtLeTS <br />_Hove _Demolish <br /> <br />WORK PROPOSED:_New Construction <br /> <br />_Addition <br /> <br />PROPOSED USE: ~Single Family <br /> <br />~M/F <br /> <br />_~~ of lIni ts <br /> <br />,._M/H <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: <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 FORHS. 1:-1: <br />**COPY OF CONTRACT REQUIRED. <br /> <br />~ERMTTS REOUESTED <br /> <br />_BUILDING <br />~ELECTRICAL <br />_MECHANICAL <br /> <br />$ <br /> <br />v~luation of Total Construction <br /> <br />AMP Service <br /> <br />Florida power Corp. <br /> <br />_H.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />.... . <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 />~ONTRACTOR 0ECTION <br />Company <br />State Cert. or Regist. 0 <br />City License Registration 0 <br />****************************************** <br /> <br />nmLDER <br /> <br />:T:::lt:".~ Company p..v>V'i < (;:;U\t:"J,j, THe. <br />: _ _ _ _ '. S ~a te Cert. or ":" is t. ." =-~~ Ot,O 7 J?fl' I' <br />ry ~ f C1ty L1cense RegJ,strClt1on,ft 1:17 <br />............................*.,.*.*****. <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 6 <br />City License RegistrCltion a <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />StAtP Cert. or Regist. 0 <br />City License Registration 0 <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration 0 <br /> <br />pTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />~, / :*********~~********':***************** <br />"'q .-,,{l Q/) fV'" . <br /> <br />PERHIT OFFICER. <br />