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<br />APPLICATION FUR PERKIT <br />GI'IY OF ZEPII1'RHILLS <br />BUILDDiG DEPARIlIIENT <br /> <br />OWNER · S NAKE <br /> <br />~ c.--f/.- +sZ 0/'/ (:, e-k.e w s;,J;! PRONE <br /> <br />OWNER' S ADDRESS <br /> <br />.JOB ADDRESS <br /> <br />c5 % ~7 ? <br /> <br />5YE <br /> <br />LEGAL DESCRIPl'Imi: LOT(S) <br /> <br />BJ...OCK <br /> <br />SlDBDIVISIO~ <br /> <br />PARCEL I. D _ f <br /> <br />o 2 --.2-b~.2/ ~ 00/0 <br /> <br />-OGOn <br /> <br />00 / () <br /> <br />WRK PROPOSED:_Nev Construction _Addition _Alteration _Repair _Install <br /> <br />~Sign <br /> <br />_l!Iove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_"'F <br /> <br />_, of llInits <br /> <br />_K/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_S,"-. Pool <br /> <br />Other <br /> <br />_Restaurant &: Health Depart:aent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COftKERC'IAL : <br /> <br />ATTACH (2) PI..OI' PI...MiS &: (2) SEIS OF BUILDING PIAIlilS &: (1) SEf RNERGY FORKS. u <br />ATI'ACH (3) SEIS OF BUllDIBG PIAIlilS &: (1) SET mmRGY FORKS.-&--:l- <br />..COPV OF CON'l"KAcr ~. <br /> <br />PERKITS REQUESTED <br /> <br />~BUILDING <br /> <br />CC <br />$ ~~ Odic> ~ <br /> <br />Valuation of Tot:al Construction <br /> <br />_ELECTRICAL <br /> <br />AKP 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 GAS ROOFDfG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FInSHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PRO.JEcr IN FlOOD ZONE AREA? <br /> <br />YES NO <br /> <br />...-&-.................................*..*. <br /> <br />BUILDER <br /> <br /> <br /><'i4~ ~~~c. <br /> <br />State Cert. or Regist. , <br />City License Registration , <br />....................-&-.............. <br /> <br />aJMI'RACIOR SECTION <br /> <br />OOIIPBY Ho/C/4 <br /> <br />Signature <br /> <br />rD. <br /> <br />...J'~fL <br />./&( t:Jt?~ S- ~f 7 <br /> <br />~CTRICIAN <br /> <br />CU!lPMIY <br />State Cert:. or Regist:. , <br />City License Registration I <br />**.**...**....**..................*.....** <br /> <br />I), S 12113 ture <br /> <br />PLOKBER <br /> <br />Signature <br /> <br />CO!IPAKY <br />State Cert. or Regist. , <br />City License Registration # <br />.........................................-&- <br /> <br />KECllANICAL <br /> <br />Signature <br /> <br />CO!IPMiY <br />State Cert. or Regist. # <br />City License Registration I <br />..............**.~........*..........*..** <br /> <br />01'1IF.R <br /> <br />OOIIPAKY <br /> <br />Signature <br /> <br />;_~r-.~.I:e C'~rt:. or Regiz"!:.. '_... <br />City License Registration j <br />.**.******....*******.......*******....... <br /> <br />APPLICATION APPROVED BY <br /> <br />II "'-"h J' 0~.;2/1 -'~ <br /> <br />PERKlT OFFICER. <br />