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<br />APPLICATIODiil FOR PERKlT <br />CITY OF ZEPIIYRBlLLS <br />BmI.DDiG DEPARllIEXT <br /> <br />OWNER'S <br /> <br />IlAIIE ~/, /l. Vq 'ij j (lrj <br />ADDRESSJ ~/3 (" ~t J</~ /?.<! <br />&/~? rf ~~ tRc( <br /> <br />PHONE 7 J7;;;J - )I~~ / <br /> <br />2~ ,:JAy f); lie;. <br />, , <br />L'7'L7 ,- .(.; / " <br /> <br />OWNER'S <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: IDI(S) <br /> <br />BLOC:K <br /> <br />SlmDIVISIODiil <br /> <br />PARCEL I. D . :f <br /> <br /> _Sign _lIfove _Deaolish <br /> ~ <br />PROPOSED USE: Single Faaily _"IF _, of Units <br /> .L-ec:-ercial _Indust. _Swt.. Pool <br /> <br />WORK PROPOSED:_OOev Construction _Addition _Alteration _Repair _Install <br /> <br />tfe ^'tc7 Ve. ;( t0~! Is <br />I /l 5-1~ 1/ -Y II jA+s; <br />_KID <br /> <br />Other <br /> <br />_Restaurant &: Hea1t:h Depar-=-ent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COHKERCIAL : <br /> <br />ATTA.CH (2) PLOT PI.ANS &: (2) SEI'S OF BUILDING PLANS &: (1) SET KNERGY FORMS. ** <br />A.TTACH (3) SEI'S OF BUILDING PI.ANS &: (1) SET ENERGY FORKS. ** <br />**COPY OF CODiilTRAC'l' REQIDlUlD. <br /> <br />PERKITS REQUESTED <br /> <br />/' BUILDING <br /> <br />$ <br /> <br />~D <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_HECHAHICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLUKBING GAS Kf!OFlliG <br />TYPE OF CONSTRUCTION: _Block _Pralle _Steel <br /> <br />SPEcIALTY <br /> <br />Other <br /> <br />FTIiISHED FlJX)R ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PROJECT IN FlJX)D ZONE .AREA? <br /> <br />YES NO <br /> <br />***~*~************************************ <br /> <br />c:orn'RACIOR SECTION <br /> <br />BUILDER <br /> <br />COIfPDlY <br />State Cert:. or Regist. , <br />Ci~ License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />D - J1~ <br />~:t] COIIP...... <?-v< ~ 's I \"2"'1<< . ~ +0. <'> <br />. State Cert. or Regist:. ,EPtOO ? ~ <br />S1 ature ~~ _ ~ City License Registration t 9n '7 <br />*********************************** <br /> <br />PLOKBER <br /> <br />COIfPARY <br />State Cert:. or Regist:. , <br />City License Registration I <br />****************************************** <br /> <br />Signature <br /> <br />KECllANICAL <br /> <br />COIfPANY <br />State Cert. or Regist.1 <br />City License Registration , <br />****************************************** <br /> <br />Signa ture <br /> <br />011IER <br /> <br />COIfPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />. <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />/7c.M h ~ _:1!O./).A)A )-- <br /> <br />PERKIT OFFICER. <br />