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<br />APPLICATION FOR PERNl'f <br />CITY OF ZEIlllY lUll LI.S <br />BUILDING DEPARTNENT <br /> <br />AIlPLlCANT Ilc~ Ilt-v( /J) , <br />ADDRESS JPS'l~ ,tJ/J~~ b/2PJI.c /}~, <br />OWNER jJ1tJfJ1I9S .8I9Lt/tI'll/J <br />JOB LOCA'flON.lorh/rp ~//}6E~4Y lJ/Z. <br />.}6' <br />U:G.^l. DES~RIPTION: LOT(S) J <br /> <br />2-#/i/t-S" fin. <br /> <br />PIIONE <br /> <br />7?~-~~/b <br /> <br />. <br /> <br />2-J..JII.A6 rill. LOT SIZE h6 <br />BLOCK ~~ SUBDIVISION <br /> <br />x/Clo AREA SQ.FT. 6.PR <br />~I <br /> <br />PARCEL 1. D... ..3 - .2t~~;). I - t' /.10 - tltfJtfJt:J{1 ,- t1d6CJ <br />WORK PROPOSED: ~w Construction ____Addition ____Alteration ____Repair <br /> <br />____Install <br /> <br /> _Sign/Temp. _Sign ____tlove ____Demolish <br />PROPOSED USE: ~ingle Family _M/F ____.. of Units ,_H/ II <br /> _Commercial _Indu6t. ____Swim. Pool Other <br /> _Restaurant & Health Department Approval <br /> <br />nUUOING SIZE: <br /> <br />9 X /.2 <br /> <br />/t?R / <br /> <br />Squ(ue Fee t I <br /> <br />3'9 "rl7t9 P , <br /> <br />lIeighl <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING llLANS & (1) SET ENERGY FOR~tS." <br />COUHERCIAL: Al"fACIl (3) SETS OF UUILDING l)l.ANS & (1) 51::'1' ENERGY l~OlUlS. ** <br />"COpy OF CONTRACT REQUIRED. <br /> <br />PERMITS REQIJESTEO <br /> <br />/BUILDING <br /> <br />$ <br /> <br />'115Cf.OO <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 />._HECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />~Pl.UMBING GAS <br /> <br />ROOFING SPECIALTY <br />Vprame _Steel IILI1I11.... Cp~R5r~Other 0 <br /> <br />~ <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />flNISlIED FLOOR ELEVATIONS: FT. <br /> <br />. , <br />********************.***...*.............* <br /> <br />Signature <br /> <br />I1cE hi-I{ ff}_ <br />kL/~;L '- <br /> <br />CONTRACTOR SECTIOti /1 - dL tJIn . <br />COlllpuny aCe /7 ./l <br />StaFe Cert. or Regist. 4. C.t:..cD .:i'L/t.Ro <br />City License Registration II /6C> <br />.**.*.*...*.*******.*..~*..**.*..~****.*.* <br /> <br />.lUIlI.DF.R <br /> <br />Siunature <br /> <br />Company <br />State Cert. or Regist. /I <br />City License Registr~tion II <br />...***.******.*****.*..*****.........*.... <br /> <br />llf,CTRICIAN <br /> <br />Company <br />State Cert. O' Regist. /I <br />City License Reaistfation II <br />**...**.*****..**.*****.**..***..********* <br /> <br />rI.UHRF.R <br /> <br />.~~nature <br /> <br />.' <br /> <br />tU;:CIIANIGAI. Company <br />StaLe Ce~t. or Resl~t. II <br />Signature City License RegIstration a <br />***~.*.*.**..********.*..*.*****.***..***. <br /> <br />UIIIF.R Company <br />State Cert. or Regist. II <br />Signature City License Registration /I <br /> <br />APP~ICATI0N APPROVED BY PERMIT OFFICER. <br /> <br /> <br />'. <br />