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<br />APPLICAT.iOl!il J}10R l'RRlIfi.T <br />CI'IY OF ZEPBYRBILLS <br />BOILDIliG DEPARI'i?IEWr <br /> <br />OWNER'S HAHE ~I/\ e C f (' ~ I- #~ t, h... <br />OWNER'S ADDRESS C(, 5- SO/-I G~(-j~ <br />JOB ~DRESS &~33 ~,/IJ /;tJl ( <br /> <br />,1<~ @Vlmoe <br />/') J <br />~(.x... <br /> <br />LEGAL DESCRIPTIOl!i: UJI'(S) <br /> <br />~SUBDIVISIOl!i <br /> <br />PARCEL I. D. f <br /> <br />WORK PROPOSED:_l1ew Construction ~itiOh _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_KIF <br /> <br />_, of llInits <br /> <br />_K/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_S..n.-. Pool <br /> <br />Other <br /> <br />_Restaurant &: Health Dcpart:aent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />_ RESIDEHTIAL: <br />cottKERCIAL : <br /> <br />ATTACH (2) PI.OI' PLAJ!iS &: (2) SILTS G~ BUILDING PLUS &: (1) SET ENERGY FORKS. ** <br />ATTACH (3) SILTS OF BUII.DDiG PLAJ!i~S &:. (1.) . SET mrnR: GY. FORIfS. ** <br />**COPY OF CONTRA~(H:RED. 1 j ~ <br /> <br />c:?o V( (~ . -~ ID 4 <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Fl;')rida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_HEGllAHICAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />~PLUKBING GAS ROOFDlG <br />TYPE OF CONSTRUCTIOl!il: _Block _FraIIe ___Steel <br /> <br />SPECIALn" <br /> <br />Other <br /> <br />FIIiISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PRO.JlJ:CT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />ClWI'RACIOR SECTION <br /> <br />BUILDER <br /> <br />Signature <br /> <br />COl!IPAlNlY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />ELECTRICIAN <br /> <br />COl!IPMY <br />State Cert. or Regist. , <br />City License Registration t <br />****************************************** <br /> <br />SiPl1::1ture <br /> <br />PumBER 2 <br /> <br />Signature ' .~ <br /> <br />IXIIIPAIIY G [" ((~ -"' r <br /> <br />State Cert. or Reg1s . #/: <br />City License Registration t <br />****************************************** <br /> <br />1 <br /> <br />It>'( crt- <br /> <br />/) <br />f; &'U1/\ J. ~ <br /> <br />~ <br /> <br />('" --c: ~ <br /> <br />KECllABICAL <br /> <br />Signature <br /> <br />COl!IPANY <br />State Cert. or Regist. I <br />City License Registration I <br />************************~v**************** <br /> <br />0T1JF.R <br /> <br />Signature <br /> <br />COl!IPANY <br />State Cert. or Regist. I; <br />City License Registration , <br />************************~***************** <br /> <br />APPLICAnOfl API'KOVIID BY 11.~~ ,!f ,v)",D-U" <br /> <br />PERKIT OFFICER. <br />