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<br />Io,PPLICANT <br /> <br /> <br />. " <br />APPL'ICAT1.QN FOR PERNI.T <br />, CITY OF ZEPIIYRlIILLS <br />1\ l BUIt.pING DEPARTI'1ENT <br />f..JV~('f.~ . <br /> <br />nONE 7P"Z. ~76'~ 9' <br /> <br />,\DDRESS <br /> <br />OWNER ' <br /> <br />LOT SIZE_____X AREA SQ.FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK <br /> <br />PARCEL 1. D. ~~ <br /> <br />WORK PROPOSED:____New construction ~Addition <br /> <br />____Sign/Temp, ____Sign <br /> <br />PROPOSED USE: ____Single Family <br /> <br />~M/F <br /> <br />____~~ of Uni ts <br /> <br />, .____1'11 H <br /> <br />____commercial <br /> <br />____Indust. ,____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 BUILDINC PLANS & (1) SET ENERGY FORMS.-- <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORHS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />Ef.RM1TS RF.OUESTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />____ELECTRICAL <br />.,tL,MECHANICAL <br />_PLUMBING <br /> <br />AMP Service' <br /> <br />Florida power Corp. <br /> <br />_W.R.E.C. <br /> <br />$9~ '1~1 tJ() <br /> <br />.#1'.. . <br /> <br />Valuation of Mechanical Installation <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 ~ECTI0N <br />Company <br />State Cert. or Regist. Q <br />City License Registration a <br />****************************************** <br /> <br />nun.DER <br /> <br />Signature <br /> <br />Si'mature <br /> <br />Company <br />State Cert. or Regist. a <br />City License Registration a <br />****************************************** <br /> <br />El.ECTRICTAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. a <br />city License Registration a <br />********************.****** <br /> <br />EJJTMRF.R <br /> <br /> <br />Campa <br />Q State Cert. <br />~7 &4-!) City License Registration j~ <br />************************-***************** <br /> <br /> <br />? <br /> <br />" <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />" <br /> <br />" <br /> <br />!lTHF,R <br /> <br />APPLICATION APPROVED BY <br /> <br />**~**,*!**********~********************** <br /> <br />'i/, : A.. ~4 r '1,vi <br />p. . <br /> <br />PERI-lIT OFFICER. <br />