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<br />APPLICATION FOR PERtlIT <br />CITY OF ZEPIIYRlIILLS <br />BUILDING DEPARTMENT <br /> <br />eAt ~ .. <br />PH~:~ 7't~,,-g/3 <br />rHu.((H <br /> <br />" <br /> <br />APPLICANT <br /> <br />51 i 0tWJ4j) (l-fRiAJ;-c <br />ADDRESS ,3 ?5.~ ()2. /;' '';-( AUP' <br />/3 T- ~,s~f';J CatNoL,( <br />JOB LOCATION -::? (sf, Cj.() (Z, rJ./-t A-VG- <br /> <br />OWNER <br /> <br />LOT SIZE_X <br /> <br />AREA SQ. FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D .l~ <br /> <br />WORK PROPOSED:____New Construction ____Addition --Alteration _Repair ____Ins tall <br /> ____Sign/Temp. ____Sign _Nove ____Demolish <br />PROPOSED USE: ____Single Family _M/F _l~ of Units ' .____M I H <br /> ____Commercial _Indust. ____Swim. , Pool Other <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 FORHS, ** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />pERM1TS REOUESTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida power Corp. <br /> <br />_W.R.E.C. <br /> <br />____MECHANICAL <br />XPLUMBING <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block _Frame <br /> <br />____Steel <br /> <br />Iyq,s/I ~ l~ho/t <br />W/+/-I tua et. Heatef- <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />~ONTRACTOR SECTION <br />Company <br />State Cert. or Regist. # <br />Ci ty License Regis tra t ion j~ <br />****************************************** <br /> <br />nmLDER <br /> <br />Signature <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />ET.ECTR1C1AN <br /> <br /> <br />Company <br />State Cert. or Regist. 0 ~ <br />City License Registration <br />****************************************** <br /> <br /> <br />Signature <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />MECHAN1CAL <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY ~;;:~...~~:::;;:;*...~*'*.***.*..** PERMIT OFFICER. <br /> <br />Company <br />State Cert. or Regist. U <br />City License Registration # <br /> <br />pTHER <br />