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<br />OWNER <br /> <br />--~Sk I:: 11;,)) E 12- <br />.:;-fpdy (! A~/E Li- <br />--JDA N IV E- S /<..E IU /) {:;JL <br />JOB LOCATION ,AS-td t/ {! A;:? IE (:7 I' 2 <br />I' <br /> <br />JCSC/lh i <br />I I . <br />'./ () t4 /....' IV E- <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEP~qILLS <br />BUILDING DEPARTMENT <br /> <br />APPLICANT <br /> <br />ADDRESS <br /> <br />PHONE ;7 j7..l- -3/-5-.1.. <br />/ <br /> <br />/-1, / Is LOT SIZE <br /> <br />X AREA SQ.FT. <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I. D. 4~ <br /> <br />WORK PROPOSED:____New Construction ----Addition ----Alteration ____Repair ____Install <br /> <br />____Sign/Temp. <br /> <br />__Sign <br /> <br />_Move <br /> <br />____Demolish <br /> <br />PROPOSED USE: ____Single Family <br /> <br />~/F <br /> <br />____4~ 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 />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 FORMS.** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS 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 /> <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 _Frame ____Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: FT. <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br />Company <br />State Cert, or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Silmature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />ELECTRTCIAN <br /> <br />Company <br />State Cert, or Regist. # <br />City L~cense Registration # <br />****************************************** <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br />****************************************** <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />Company <br />State Cert. or Regist. # <br />City License Registration # <br /> <br />OTHER <br /> <br />Signature <br /> <br />****************************************** <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />