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<br />APPLICATION FOR PERMIT <br />CITY OF ZEIllIYRlllLLS <br />BUILDING D~I)ARnIENT <br /> <br />Al)PLICANT <br /> <br />IJcE' <br /> <br />A/... J( r'l <br /> <br />OWNER <br />JOB LOCA'fIONLPr-/~ <br /> <br />7HCJA1A~ <br /> <br />..frs-~s Pt}LPI CROvL LJ~, <br />. <br /> <br />EL.Le~ <br />6~()S' It.:ztt ...r;,; <br />t>01. <br /> <br />PHONE <br /> <br />7t1;) - ;)b/ b <br /> <br />AnDRESS <br /> <br />I,EG..\{, DES{;RIPTION: LOT(S) <br /> <br />LOT SIZE-ZtX //)S AREA SQ. FT. dJ s;-~ <br />BLOCK ;J.~ SUBDIVISION a?/.. L.1 /.Pd" i?t:?ddt?...P/</J <br /> <br />PARCEL I. n ,I~ <br />WORK PROPOSED: ~New Construction ~Addition _Alteration ____Repair <br /> <br />____Install <br /> <br />_Sign/Temp, <br />PROPOSED USE: ~ingle Family <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Demolish <br /> <br />_M/F <br /> <br />_It of Units <br /> <br />._H /11 <br /> <br />_Commercial <br /> <br />_lndu6t, <br /> <br />_Swim, Pool <br /> <br />Other <br /> <br />_Restaurant & lIealth Department Approval <br /> <br />nUll.DING SIZE; 9 X Jt> yR c:J~ Square Feet, t? '~C 7' lIeighl <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF nUILDING PLANS & (1) SET ENERGY FOR~IS . * * <br />CUttttERCIAL ; A 'l"r ACIf (3) SETS OF DUll.DING l'I..ANS (. (I) SI::T EN&::RGY fORt-IS. * * <br /> HCOPY OF CONTRACT REQUIRED, <br /> <br />PERMITS REQUESTED <br /> <br />/' BUILDING <br /> <br />$ <br /> <br />;)'Il'f,OtJ <br /> <br />Valuation ot Total Construction <br /> <br />_ELECTRICAL <br /> <br />Al'tP Sel'vice <br /> <br />Florida Power Corp, <br /> <br />._H,R.E.C. <br /> <br />._MECHANICAL <br /> <br />$ <br /> <br />Valuation ot Mechanical Installation <br /> <br />~PI.UMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />T;PE OF CONSTRUCTION: ____Block ~Frame _Steel <br /> <br />ALIJJ'l. <br /> <br />Other' <br /> <br />flNISIIED FLOOR ELEVATIONS: FT, <br /> <br />, I <br />.*....*******...***.****.*.***.*********** <br /> <br />Signature <br /> <br />J1J'.:' Ll, IA ""'. . CONTRACTOR SECTIQti A'.# L' II <br />{L1I(;" nl-Y" "J _ COlllpuny ~ nLIlt,P'}. <br />StaFe Cert. or Regist. II CIPt:t:),..i'y~S'p <br />City License Registration It /bt:J <br />***********........**.*$******.....*.*a.** <br /> <br />.\H111.PF.R <br /> <br />.&LECTRIC1AN <br /> <br />Siunqture <br /> <br />Company <br />State Cert, or Regist. It <br />City License Registration II <br />*.*.*..*.*.........*...****.*....*.*...... <br /> <br />1)I.mtBER <br />~~knature <br /> <br />Company <br />State Cert. 0' Regist, It <br />City License Registration # <br />****..****..****..****.*****.********...** <br /> <br />tlECIlAN1CAl. <br /> <br />Signature <br />.. <br /> <br />Company <br />State ~crt. or Resist, It <br />City License ReGistration # <br />.*************..***************.a*******.* <br /> <br />OIliER <br /> <br />Signature <br /> <br />Company <br />State Cert, or Regist, It <br />City License Registration It <br /> <br />*******.**..*..**************..*****.***** <br /> <br />APP~ICATION APPROVED 8Y <br /> <br />PERMIT OFFICER. <br /> <br />'. <br />