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<br />APPLICATION FOR PERI-lIT <br />CITY OF ZEPHYIDnLLS <br />BUILDING DEPART1'1ENT <br /> <br />JOB LOCATION <br /> <br />t!n126/1,(cr fft/IV/VCl <br />j~c;O)- '? -r--&/ ~ <br />r(lJt+t~ <br />ts kit (.., <br /> <br />PHONE <br /> <br />. 7sr-'" 1069 <br /> <br />APPLICANT <br /> <br />ADDRESS <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. i~ <br /> <br />II <br /> <br />~ r2-1 <br /> <br />ODIO <br /> <br />~rocJ1j <br /> <br />O;LI { <br /> <br />WORK PROPOSED:____New Construction ____Addition ____Alteration ____Repair ____Install <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 />_it of Units <br /> <br />,._M/H <br /> <br />_Commercial <br /> <br />_Indust. <br /> <br />_Swim. Pool <br /> <br />Other <br /> <br />_Restaurant & Health Department Approval <br /> <br />BUILDING SIZE: <br /> <br />6 X (p <br /> <br />, f,~- Ffh3 . 5'1r4) <br /> <br />Square Fee t, <br /> <br />3la <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COill1ERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORl'1S.** <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY fORHS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />rERMTTS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />1'9J <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 /> <br />$ <br /> <br />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 />nllTLDEE S;dA/S~ It? 'l::= CQNT~~;~~n~EcnON <br /> <br />iY / /-f /, " State Cert. or Rcgist, II <br />Signature ~ .fA); ( {; .' City License RcgLstr,ltion iI <br />****************************************** <br /> <br />'11 <br /> <br />Si!!nature <br /> <br />Company <br />State Cert. or Regist. II <br />City License Registration 0 <br />****************************************** <br /> <br />E1.ECTRTCTAN <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. !I <br />City License Registration iI <br />****************************************** <br /> <br />P1.UMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist, 0 <br />City License Registration II <br />****************************************** <br /> <br />!-lECHAN1CA1. <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. 0 <br />City License Registration 0 <br /> <br />OTHER <br /> <br />APPLICATION APPROVED BY <br /> <br />"fl * * * * * * * * ~ * * * 1c * * * * * * * * * * 1c 1, ;, ,', ;, ;, ,',;, ,', ,~ ;, * ;, ;, <br />11.A1~~' "A~ ",..' .. <br /> <br />PER~lIT OFFICER. <br />