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<br />; ,t":.J.:.'/. <br />APPLICATioN FOR PERNIT <br />CITY OF ZEPIiYlUl:tLLS <br />BUILDING DEPARTMENT <br /> <br />;; 'I'" " ' <br /> <br />'~A,J~:V j);6~:' eo r-~ <br />1f:~~~r <br /> <br />31JO/cf ~..~. LOT SIZE <br />LEGAL DESCRIPTION: LOT(S) J '. BLOCK <br /> <br />APPLICANT <br /> <br />." <br /> <br />ADDRESS <br /> <br />PHONE <br /> <br />:5h7~79P;L. <br /> <br />. <br /> <br />OWNER <br /> <br />.... <br /> <br />JOB LOCATION <br /> <br />. , <br /> <br />x <br /> <br />AREA SQ. FT. <br />11tScto f1;/poJCA1/)rfJ~fr_ <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. if <br />WDRK PRDPDSED,_New Construction ~ddition )<.Alterotion _Repair _Install <br />_Sign/Temp. ----..:Sign _~lo\!e _Demolish <br /> <br />PROPOSED USE: ~Single Pamily <br />Acommercial <br /> <br />~/F <br /> <br />_if of lIni ts <br /> <br />,._H/lI <br /> <br />~Indust. <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />_Restaurant & IIealth.Department Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Pee t, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMl'iERCIAL : <br /> <br />A TTAClI (2) PLOT PLANS & (2) SETS OF BUILDING PLANS << (1) SET ENERGY FORl-iS. ** <br />ATTACH (3) SETS. OF BUILDING PLANS & (1) SET ENERGY PORHS. H <br />**COPY OF CONTRACT REQUIRED. <br /> <br />_BUILDING <br /> <br />$ <br /> <br />~ fd. rPC2- <br />.:> /JQ <br /> <br />PERMITS REQUESTED <br /> <br />. Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AHP Service <br /> <br />Florida Power Corp. <br /> <br />_H.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />~ <br />~ <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br />.... <br /> <br />TYPE OF CONSTRUCTION: _Block <br /> <br />_Frame _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. . <br /> <br /> <br />. CONTRACTDE :;EC~~ ~A_ 7~ <br />. Company If/~(/ fl CO <br />tate Cert. or Rc.gis t. 1J 1'_ 0 / 2- 9' ';l. ~ <br />. Ci ty License Regis tra t ion if / R' <br />*********R*U******~***~**U** <br /> <br />ELECTRTCTAN <br /> <br />Company <br />State Cert. or Rcgist. if <br />City License Registration if <br />****************************************** <br /> <br />Si!!nature <br /> <br />" <br /> <br />.PLllMBER A .('. P4 6,~( <br />Signature~./ ~~- <br /> <br />. Company .4 ~ bk4~~t k1-:< 4r <br />. State Cert. or Regis t. {! C <br />City License Registration {J <:)..7 <br />****************************************** <br /> <br />1'1ECHANTCAL <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration U <br />'****************************************** <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br />Company <br />State Cert. or Regist. if <br />City ~cense Registr~tion ff <br /> <br />'. <br /> <br />OTHER <br /> <br />APPLICATION APPROVED DY <br /> <br />PERl-fIT OFFICER. <br />