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<br />APPLICATIOllil FOR PERKIT <br />CI'IY OF ZEPBYInULLS <br />BUIIJ)llIG DEPARl1!lE'BT <br /> <br />OWNER'S MAIfE <br /> <br />\~,~ <br />5l)~ \ <br />~N\e <br /> <br />~0QN('P\ <br /><a \-'n ~Pe.\- <br />a~ c\~"'Q <br />l\\ ,I\, .~..\<1, <br />\)(~')~ \ ~~O p <br />, <br /> <br />mon <br /> <br />OWNER'S ADDRESS <br /> <br />co~ ~\ ,\ 'n, \ \-::> <br />\ <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: I.OI'(S) <br /> <br />~\~\ <br /> <br />BLOCK~StmDIVISIOllil \C~ ...'.N ()\ ?: O\)X\.\ \~'r;\ D <br /> <br />PARCEL I. D. t <br /> <br />~~ <br />. , <br /> <br />WORK PROPOSED :_Xfev Construction _Addition _Alteration .,---Repair ~Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />lke <br /> <br />Faaily <br /> <br />_KIF <br /> <br />_, of Ufnits <br /> <br />_K/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Stria. Pool <br /> <br />Other <br /> <br />_Rest:aurant &- Hea1t:h ~t Approval <br /> <br />BUILDIIfG SIZE: __X <br /> <br />Square Feet, <br /> <br />Height <br /> <br />. RESIDEIfTIAL: <br />COHKERCIAL : <br /> <br />ATTACH (2) PLOI' PLAIIS &- (2) SEIS OF BUILDING PLAJlS &- (1) SEI' ENERGY FORKS. ** <br />ATTACH (3) SEIS OF BUILDDiIG PLAIIS &- (1) SEI' mmRGY FORKS. *..... <br />.....*CO Ill" OF COllilTKACT RIlQlDIRIID. <br /> <br />PElmITS REQUESTED <br /> <br />_BUILDIIfG <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KECHAliICAL <br /> <br />s <br /> <br />"Valuation of Hecbanical Installation <br /> <br />_PUJKBIIfG GAS __lIDOFIiliG <br /> <br />SPECIALTY <br /> <br />TYPE OF COIfSTRUCTl OIN!: _Block _FraIIe _Steel <br /> <br />Other <br /> <br />FllIISHED FLOOR ELI VATIOllilS: <br /> <br />FT. <br /> <br />IS PROJECT DI FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />....*********.**************************** <br /> <br />(X)II"I'RACI'OR SECTION <br /> <br />BUTT J)ER <br /> <br />~o 1 () ~ ~'t \~Q() <br />- <br /> <br />CO!tPAft \,\\c\ ~'l\t\~ ~Q~(,P <br />St:ate Cert. or Regist. , <br />City License Registration' \I..\~ <br />****************************************** <br /> <br />~ \f\\C <br /> <br />Signature <br /> <br />ELECTRICIAN CO!tPMiY <br />St:ate Cert. or Regist. f: <br />Si~ature City License Registration I <br />**************************.***.****.**..** <br /> <br />PWKBER CO!tPMO'- <br />St:.&t.€c (.;erL uL Regisl:. :: <br />Signature City License Registration I <br />**.*******.**************...****...*..**** <br /> <br />KECHAlUCAL CO!tPMY <br />St:ate Cert. or Regist. I <br />Signature City License Registration I <br />**.*************************************** <br /> <br />OTHER CO!tPMJY <br />Stat€ Cert. or Regist. f <br />Signature City License Registration , <br />******************.****.****************** <br /> <br />APPLICATION APPRm"F.D BY PERKIT OFFICER. <br />