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<br />~ITAJ.L( <br /> <br /> <br />APPLICATION FOR PERI-lIT <br />"^ n,~ ~/) CITY OF ZEPIIYR:nLLS <br />I~~ ~ING DEPARniENT <br /> <br />HONE <br /> <br />~~Z-...... 2-9 '? 9 <br />.. ' <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />" <br /> <br />OWNER <br />JOB LOCATIO~_~~~ <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />~.-. <br /> <br />~d'V~- <br /> <br />LOT SIZE <br /> <br />x <br /> <br />AREA SQ. FT. <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED:____New Construction <br /> <br />~Addition <br /> <br />~1r~~ <br />____Alteration ____Repair ____Ins 1 <br /> <br />PARCEL 1. D. ~~ <br /> <br />____Sign/Temp. <br /> <br />____Sign <br /> <br />_~love <br /> <br />_Demolish <br /> <br />PROPOSED USE: ~Single Family <br /> <br />~M/F <br /> <br />_f~ of Uni ts <br /> <br />, .____1'1/ H <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />____Swim.. Pool <br /> <br />Other <br /> <br />_Restaurant & Healt~ 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 FORr-lS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />:pERMITS REOUESTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />____PLUMBING <br /> <br />,b AMP ~ervice <br />$ 3! ,/0, rJ () <br /> <br />GAS <br /> <br />Florida power Corp. <br /> <br />_H.R.E.C. <br /> <br />____ELECTRICAL <br />~CHANICAL <br /> <br />Valuation of Mechanical Installation <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 />****************************************** <br /> <br />Signature <br /> <br />~ONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />City License Registration D <br />****************************************** <br /> <br />nlJ1LDER <br /> <br />Sif"l1ature <br /> <br />Company <br />State Cert. or Regist. D <br />City License Registration D <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. ~ <br />City License Registration D <br />************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br /> <br />*1(")'(....(-{:-.:,*.;:--::*oJ:-!:...';~r: 3. 1 j~~j"'-" <br /> <br /> <br />-S.*~!4Ql.-"?)C4. <br />r Regist. f! I/?~A (9~jljf/ <br />t::; d. City License Registration!i :? <br />****************************************** <br /> <br /> <br />" <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0_ <br />City License Registration # <br /> <br />OTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />*************~*************************i' <br />57 tt-1'L<' Act' '""" '" "i'~)- , <br /> <br />.1 <br /> <br />PERl-lIT OFFICER. <br />