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<br />APPLICA:ITOlNl FOR. PERMIT <br />CITY OF ZEPIIYlmILLS <br />BUILDIlNlG DEPARTlIfENT <br /> <br />~ <br /> <br />z . r fVl. !J1fV21-Yl/flL~ <br />OWNER'S ADDRESS 6 7 3 ~ b <br />Sitt11 L <br />LEGAL DESCRIPTION: I..01'(S) SE.c..~'O/t7 <br /> <br />OWNER'S RAttE <br /> <br />PHONE <br /> <br />?Bl-3B60 <br /> <br />r!)1 Pc,vC E. V <br />I <br /> <br />AD <br /> <br />JOB ADDRESS <br /> <br />" ~~ 7/;W/tlShif" 2-b 'R ~ ~7'Z. <br /><::oL BI.9CK, SUBDIVISION, <br /> <br />::L I s /'t-')+ ~c,D (0. <br /> <br />PARCEL I. D.' <br /> <br />WRK PROPOSED:-X-New Construction _Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_lIfove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_KIF <br /> <br />_' of Units <br /> <br />_K/H <br /> <br />.$-~rcial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Restaurant <br /> <br /> <br />>t i1.~ ~tJt. <br />f If Height: <br /> <br />BUILDING SIZE: 7 b X I ae , <br /> <br />RESIDENTIAL: <br />COHKERCIAL : <br /> <br />ATTACH (2) PLOt' PLAlNlS &: (2) SEIS OF BUILDING P S &: (1) SET ENERGY FORKS. ** <br />ATTACH (3) SEIS OF BUllDDilG PLAlNlS &: (1) SET ENERGY FORMS. u, <br />**COPY OF COlMTRAcr RIl'Q1JJTRED. <br /> <br />X-BUILDING <br />~ELECTRICAL <br />_HECHAlUCAL <br /> <br />PElmITS REOUESTED <br />$ SDo(}{}().(j(j' VaIuation of Total Construction <br />}JOT:> AKP Service Florida Power Corp. <br /> <br />X-W.R.E.C. <br /> <br />$ <br /> <br />VaIuatioL of Kecbanical Installation <br /> <br />_PLUH.BING GAS <br /> <br />TYPE OF CONSTRUCI'IONl: _Block <br /> <br />ROOFDiG <br />. <br /> <br />_F'nmIe KSteel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />YES <br /> <br />X <br />NO <br /> <br />FINISHED FLOOR ELEVATIONS: 76. S D Fr . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />BUILDER <br /> <br />Signature <br /> <br /> <br />5i <br />PLDmER ~/0 <br />5 ignat:ure . <br />KECllAHICAL Nlfi <br />Signa t:ure <br />0'nIF.R ift <br />S ignat:ure <br /> <br />- <br /> <br />1;IJp(ll f.17J(..~ <br />Cer1:. or Regist. j 0 (!J ( 6 () 7 '7 <br />1ty License Registration ,f C7 ~ <br />***************************** <br /> <br />COI!tPMW <br />St:ate Cer1:. or Regis1:. j <br />City License Registration' <br />****************************************** <br /> <br />COI!tPANY <br />State Cert. or Regist. , <br />City License Registration # <br />****************************************** <br /> <br />COMPAHY <br />Stat.<.. Ct~): L or Regist. , <br />City Lic~e Registration , <br />***************......********,,:****i~*********** <br /> <br />. <br /> <br />'LICAnON APPIlOVIID BY )1' 0 h\.(' ~ _~I2LJd!:hT <br /> <br />PERKIT OFFICER. <br />