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<br />APPLICATION FOR PERI-lIT <br />CITY OF ZEPHyronLLS <br />BUILDING DEPARTHENT <br /> <br />ADDRESS <br /> <br />\' . <br />I~ K ( c h c t <br />f.e to <) '):~) ,:i?~' <br /> <br />PHONE <br /> <br />~~r c;{v:V <br />"7t~ '/H7 <br /> <br />APPLICANT <br /> <br />, OWNER <br /> <br />" <br /> <br />JOB LOCATION <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, tt <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 />_~t of Uni ts <br /> <br />. .____M I H <br /> <br />____Commercial <br /> <br />____Indus t . <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.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />:EBRMITS REOUESTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />valuation of Total Construction <br /> <br />_ELECTRICAL <br />LMECHANICAL <br /> <br />AMP Service <br /> <br />Florida power Corp. <br /> <br />_H.R.E.C. <br /> <br />$ <br /> <br />t ~ {( f )- () 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 />Signature <br /> <br />~ONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration a <br />****************************************** <br /> <br />BUTLDER <br /> <br />SiO'nature <br /> <br />Company <br />State Cert. or Regist. a <br />City License Registration j~ <br />****************************************** <br /> <br />f.J.ECTRTCTAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration fl <br />****************************************** <br /> <br />PLUMBER <br /> <br />::::::::J.A $ <br /> <br />} <br /> <br />Company <br />State Cert. or Regist. 0 <br />~~~~~ City License Registration <br />** *** *********** ***** * * 'it ** * 'it 'i: * ,':;: *,~ * ,,: * *;: 1, <br /> <br />r <br />5' 0 /1/;(, /'-1 .5 <br />f<. }?^C/ 0 J f; 4: f& ( <br />IF -tI '1- <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. a <br />City License Registration a <br /> <br />QTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />**************~J************************* <br />/1 '''L1AP--<~ ~A'L-, r , - <br /> <br />PERtHT OFFICER. <br />