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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRIIILLS <br />BIlIIIJH.RG DEPARnIE1ifT <br /> <br />OWNER'S NAME f3~ 1 Sf ~? <br />OWNER'S ADDRESS to IJ~ L.-[o).oo 5/: fl..e47 ~ <br />JOB ADDRESS 38.7/ () j AI/e.- <br /> <br />PHONE <br /> <br />3L-(Lf- I b/ I <br /> <br />2.e ~A. v.e.;-./, //(' <br />I I <br /> <br />3) 7yry <br />(5r J;5ej/1 &/)////C <br /> <br />(/",.<4 ) <br /> <br />LEGAL DESCRIPl'Imi; wr(S) <br /> <br />BI.OCK <br /> <br />SIlIBDIVISION <br /> <br />PARCEL I. D. t <br /> <br />WORK PROPOSED:_Nev Construction _Addition -X-Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_"IF <br /> <br />_' of Units <br /> <br />_KID <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />Swa. Pool <br /> <br />(,1&1" ct <br /> <br />Other <br /> <br />_Restaurant &: Heal.t:h Departaent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COHKERCIAL : <br /> <br />AtTACH (2) PLOT PLAliS &: (2) SEIS OF BUILDING PLUS &: (I) SEI' DERGY FORKS. u <br />ATTACH (3) SEIS OF BUllDDilG PLAliS &: (1) SEt' ENERGY FORMS. ** <br />**COPV OF COIITRAC1" KEQIlIIRED. <br /> <br />PEKKITS KEOOESTED <br /> <br />LBUILDING <br />..LELECTRICAL <br />~KECllANICAL <br /> <br />$ <br /> <br />7', 17(){') <br />, <br /> <br />Valuation of Tot:al Construction <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />V.R.E.C. <br /> <br />s <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFDiG <br /> <br />SPECIALIT <br /> <br />TYPE OF CONSTRUCTION: _Block ~FnDiie _St.eel <br /> <br />Other <br /> <br />FUrrSrtr.:i) FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PROJEC1" IN FLOOD ZONE A.REA? <br /> <br />YES NO <br /> <br />***********.*********************~******** <br /> <br /> <br />Cjj.;j7; ~IV(' (~/1/ST C'(). <br /> <br />=, ~ ~. S Ceet. or Regist. , C":: r;:: C 0(/ (j '7 (.) f). <br />-...... it:y License Registration , :1 '1S- <br />************...*************************** <br /> <br /> <br />ELEcygCIAN <br /> <br />,L ~ <br />. I <br />S1e:nature I <br /> <br />?~ <br /> <br />.~ <br />CO!IPANY ~ <br />State Cert. or Regis!:. , t: I? () 0 -1171( I <br />City License Regist~tion I ....'?~? 7 <br />****************.********************~~*** <br /> <br />PLOHBER <br /> <br />!/Iii- <br /> <br />CO!IPMlIY <br />State Cert. or Regist: , <br />City License Registration , <br />******************..********************** <br /> <br />Signature <br /> <br />Signature <br /> <br />rJ./ <br />/f'~~J <br />- "7 <br /> <br />CQlPAn' .:rePYf -= /ff~b <br /> <br />/',: . / S1:4t:e Cert. or Regist. , <br />u~ CitF License Registration I <br />****************************************** <br /> <br />C 1'1 .- Co S'> '-I '7 ;l. <br />/(51 b <br /> <br />~CAL <br /> <br />0'l1IER <br /> <br />.uIWJOO" NlAlRNI <br />IIlIlIA .........,.. ... <br />pf!'cY_ <br /> <br />cmtPAlWY <br />State Cert. or Regist. , <br />City License Registration , <br />*************************************** <br /> <br /> <br />PERKI'r OFFICER. <br />