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<br />/ <br /> <br />APPLICATI05 FOR PERKlT <br />CI'IY OF ZEP'IJfKIIILLS <br />BlDIIJ)I.RG DEPAR.~ <br /> <br />OWNER'S MAKE <br /> <br />/ <br /> <br />.L-" <br /> <br />PHONE <br /> <br />OWNER'S ADDRESS j/ <br /> <br />1..", <br /> <br />JOB ADDKFSS <br /> <br />-. <br /> <br />/ <br /> <br />{;/ ~l, <br /> <br />/i <br />i I \ <br /> <br />/ <br />I I <br /> <br />,--OJ ,.- <br /> <br />'L~ <br /> <br />BI.OCK <br /> <br />"'" <br /> <br />.1 <br />.~ <br />I II'/! <br /> <br />~- I ~ - . \_ <br /> <br />LEGAL DESCRIPTION: LOI'(S) <br />/ <br /> <br />SUBDIVISIOR <br /> <br />( <br /> <br />PARCEL I. D. f <br /> <br />... if' <br /> <br />\. <br /> <br />/, '. <br /> <br />WORK PROPOSED:_lNIew Construction .-Jddi..tion _A1teration ~Repair _Install <br /> <br />_Sign. <br /> <br />_Hove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />.-single Faaily <br /> <br />_KIF <br /> <br />_' of llfnits <br /> <br />_K/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swill. Pool <br /> <br />Other <br /> <br />_Kest:aurant &: Health Depart:llent Approval <br /> <br />BUILDDlG SIZE: <br /> <br />x <br /> <br />. ~ . <br />I <br /> <br />il <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL : <br />cottttERCIAL : <br /> <br />A1TACII (2) PLOY PLUlS &: (2) SEIS OF BUILDlliG PI..!\lNIS &: (1) SET ENERGY FORMS."""" <br />ATI'ACH (3) SETS OF BUILDIIlG PLUlS &: (1) SET ENERGY FORKS. ** <br />........COpy OF CONTRACT RlJ'Qm:RIID. <br /> <br />PERI!IITS REQUESTED <br /> <br />....-'-- <br /> <br />,/ <br /> <br />Valuation of Tot:a1 Constnlction <br /> <br />_BUILDING <br /> <br />$ <br /> <br />_ELECTRICAL <br /> <br />MIP Service <br /> <br />Florida Power Corp. <br /> <br />'.A <br />i_ - W.R.E.C. <br /> <br />_HECllAlfICAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />_PLUKBING <br /> <br />GAS <br /> <br />:ROOytliG <br /> <br />SPECIALTY <br /> <br />. TYPE OF CONSTRUCI'I05: _Block <br /> <br />_Fraae _Steel <br /> <br />other <br /> <br />FlliISHED FLOOR ELEVATIOBS: <br /> <br />FT. <br /> <br />IS P.RO.JIl:CT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />............*....*****................................*-1:................................................................*.................... <br /> <br />C05I'KACIOR SECTION <br /> <br />COl!fPMUY <br />State Cert. or Regist. 41 <br />City License Registration I <br />............................***............................................................................................................................* <br /> <br />BmTJ>ER <br /> <br />S i.gnature <br /> <br />Silmature <br /> <br />COl!fPMiY <br />State Cert. or Regist. I <br />City License Registration I <br />............................***................*-1:........*-1:........................................................................................ <br /> <br />ELECTRICI.AN <br /> <br />COl!fPARY <br />St:ate Cert:. or Regist:. I <br />City License Registration , <br />............................*........................................................*............................................................................ <br /> <br />PLUttBER <br /> <br />Signature <br /> <br />COl!fPAiiilY <br />State Cert:. or Regist:. I <br />City License Registration I <br />....*....................................*-1:.................................................................................................................... <br /> <br />KECBARICAL <br /> <br />Signature <br /> <br />COl!fPMiY <br />State Cert:. or Regist:. I <br />City License Registration t <br />........................................................................................................................................................................ <br /> <br />. <br /> <br />O"I"IIF.R <br /> <br />Signature <br /> <br />APPLICATIOIi APPROVED <br /> <br />BY~~~ <br /> <br />PERKIT OFFICER. <br />