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<br />~._--_..._-
<br />
<br />APPLICATION FOR PERl-lIT
<br />CITY OF ZEPIIYRIIILLS
<br />BUILDING DEPARnlENT
<br />
<br />APPLICANT
<br />
<br />WJ I- J.-./ B,P7 . ,/7 ~ A 1//1//
<br />t, t, 30 ]~~y /Y)/JrJ A DR
<br />
<br />PHONE
<br />
<br />'7f?,~
<br />
<br />7Cf f) 7
<br />
<br />ADDRESS
<br />
<br />OWNER
<br />
<br />JOB LOCATION
<br />
<br />LOT SIZE.1I2.t.LX,J# J AREA SQ. FT.
<br />
<br />LEGAL DESCRIPTION: LOT(S) ..59 - '-0
<br />
<br />BLOCK
<br />
<br />SUBDIVISION S)l VEtR
<br />
<br />o fi- J1 .s.
<br />
<br />PARCEL 1. D. U .3 - --? L - ~ J - J ~ - tJ -
<br />WORK PROPOSED:~New Construction ____Addition ____Alter3tion ____Repair ____Install
<br />
<br />____Sign/Temp.
<br />PROPOSED USE: -tl-single Family
<br />
<br />____Sign
<br />
<br />____~Iove
<br />
<br />____Demolish
<br />
<br />_H/F
<br />
<br />____# of Units
<br />-$-swim, Pool
<br />
<br />,._M/H
<br />
<br />____Commercial
<br />
<br />_Indust.
<br />
<br />Other
<br />
<br />_Restaurant & lIealth Department Approval
<br />
<br />BUILDING SIZE:
<br />
<br />~,
<br />
<br />Square Fec t ,
<br />
<br />Height
<br />
<br />RESIDENTIAL:
<br />COMMERCIAL :
<br />
<br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS.**
<br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENEI\GY FOmlS, **
<br />**COPY OF CONTRACT REQUIRED.
<br />
<br />PERMITS REOUESTED
<br />
<br />LBUILDING
<br />-A-ELECTRICAL
<br />_MECHANICAL
<br />-A-PLUMBING
<br />TYPE OF CONSTRUCTION: ____Block
<br />
<br />$ J'I; 700. ()O Valuation of Total Construction
<br />,
<br />AMP Service X Florida Power Corp,
<br />
<br />_W.R.E.C.
<br />
<br />$
<br />
<br />Valuation of Mechanical Installation
<br />
<br />GAS
<br />
<br />ROOFING
<br />
<br />~; I'ECIALTY
<br />
<br />____Frame ____Steel
<br />
<br />Other
<br />
<br />FINISHED FLOOR ELEVATIONS: FT.
<br />
<br />********************************~~~~*~****
<br />
<br />BUILDER
<br />
<br />/J --" CONTRACTOR SECTION /J I D
<br />a..8- f ..L.Q() K f_ Company t:2.8..7 5 0 t:1 () L
<br />() ~ I ~ State Cert. or r~f'r~ist. if FJPOtJ -!l9]Sf 7
<br />lA/jI}7A'~/l z!l;' _A'~.P, City License Ecr"i~';trarinn if ).,;j
<br />*********** ******** * * * *,', 1,1, *1, 'I, 1, ,', "~"'"'' '.' "~' {,,,,,
<br />
<br />
<br />A 0 ~~:~:n~cl:~tf}(o:E~~
<br />
<br />Ci ty License Rf'I',i s tra t: ion if /59
<br />*******************************~~****~****
<br />
<br />Co,
<br />
<br />Signature
<br />
<br />
<br />PLUMBER
<br />
<br />/}.J9 T . 7(; C! 1 ~ ._ Company /J #7-/ 5
<br />n --1l 0/ /J State Cert. or !\('r,isL !.f
<br />I YJ4/lU.IJ ~ ~~ Ci ty License ]{e~~is tra !:ion if
<br />
<br />~ ************************1,* * **{,'~ ,', 1, ,'", ,', {, {, 1, {,'~ ,',
<br />
<br />
<br />~ Company 1&/11/1//(' To~J 4/vAI'
<br />State Cert. or Rcr.ist. if tJtj_jj-J'(
<br />City License ReGistration #
<br />* ****** *********************************
<br />
<br />Po t'l 1-
<br />nf'ptJ
<br />
<br />(o.
<br />1J9 K97
<br />J~
<br />
<br />Signature
<br />
<br />
<br />Signature
<br />
<br />OTHER
<br />
<br />/"I.I'p fj fry
<br />
<br />IJ € ft? J N' C -:r 17 /J/'
<br />
<br />Company fJ 1E/?.1 /Vc.. -:rPA/
<br />State Cert. or Regist, 0
<br />City License Rer,istrntion n
<br />
<br />,1) Z-W/'J,
<br />
<br />7S--
<br />
<br />Signature X
<br />
<br />APPLICATION APPROVED BY
<br />
<br />
<br />PERNIT OFFICER.
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