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<br />APPLICATIOllll FOR PHRHIT <br />CI'IYOFZEPlIYRHILLS <br />mrrUn.RG DEPARDlIF..INlT <br /> <br />Ju-'.1/ d-(Pob B . <br />c- --- <br /> <br />OWNER'S MAKE <br /> <br />PIIONF. <br /> <br />OWNER'S ADDRESS <br /> <br />('z) "if-" ,,) 'tJ nL- <br /> <br />BLOCK SUBDIVISION <br /> <br />JOB ADDRESS <br /> <br />27 If /CJ <br /> <br />LEGAL DESCRIPTION: wr(S) <br /> <br />PARCEL LD.# <br /> <br />WORK PROPOSED:____~ew Construction ~ddition ____Alteration ~Repair ____Install <br /> <br />____Sign <br /> <br />____l!fove <br /> <br />____DeJlOlish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />____KIF <br /> <br />____' of Units <br /> <br />____M/H <br /> <br />____CoaBercial <br /> <br />____Indust. <br /> <br />____Swi.. Pool <br /> <br />Other <br /> <br />____Restaurant &: Dea tth Depar~t 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 PLAK. &: (2) SETS OF BUll.DING PI,ANS & (1) Sf:!' ENERGY FORMS. ** <br />ATTACH (3) SETS OF E :nLDDilG PLAlNIS &: (1) SET ENERGY FORMS. -t.-'!, <br />-4-*COPY OF col!ITRACT R SQUJIRIID. <br /> <br />PERKITS REOlW_'iTED <br /> <br />____BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Se ~'Vice <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_KECHARICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFDiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____Block <br /> <br />~ase ____Steel <br /> <br />Other <br /> <br />FIRISBED FLOOR ELEVATIONS: <br /> <br />FL <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />********~~*************-4-***-4-************** <br /> <br />roMI'RACTOR SECTION <br /> <br />COIfPMIlY <br />State Cert. or Regist. ~ <br />City License Registration #I: <br />********~***********..***********-t.-********-t.- <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Silm.3ture <br /> <br />cmlPANY <br />State Cert. or Regist. , <br />City License Registration f <br />***"...**ii.fl:-A:**-A:..-A:*-4--A:.".**.*-4-******-t.-**-t.--t.-**** <br /> <br />ELECTRICIAN <br /> <br />COIfPMiY <br />State CerL or RegisL #t <br />City License Registration f <br />*-4-**-4-""*~fl:*******"."*-4-**fl:fl:**""******-t.-***** <br /> <br />PLOKBER <br /> <br />Signature <br /> <br />Signa t:ure <br /> <br /> <br />lAJ!itP~~ C~~.!r ~I {l <br />\ State Cer . or Re st." (!)C? N7 ?-.- <br />, City License Reg straHon ~ 7/ <br />"-A:*-4-*~-4-**"*"***"-4-******~**"************ <br /> <br />KECHAJUCAL <br /> <br />CO!fPANY <br />State Cert. or Regist. #t <br />City License Registration ~ <br />..******..~-t.-**"."..,,*.*******"**"****fl:***-t.-** <br />, <br /> <br />OTHER <br /> <br />. <br /> <br />Signat:ure <br /> <br />APPLICATION APPROVED BY <br /> <br />PERHIT OFFICER. <br />