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<br />APPLICATIOIl FOR PERHIT <br />CITY OF ZEPBYRlilLLS <br />Bm:LDUIG DEP.I\KDfiJ:NIT <br /> <br />OWNER'S ADDRESS <br /> <br />.D y^ . 1/ TIt) 0 I <br />S-I S-;Z d-.I J 51. <br />)/7--,-yl--l <br /> <br />PIIO~ <br /> <br />'? $3~ ~ / I ? .$ <br /> <br />OWNER'S BAKE <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPl'IOl!lll: IDI'(S) <br /> <br />BLOCK <br /> <br />SUBDIVISIOlNl <br /> <br />PARCEL I. D. f <br /> <br />WORK PROPOSED:_llev c;.onstruction _Mdition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single Faaily <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_M/H <br /> <br />_eo..ercial <br /> <br />_Indust. <br /> <br />_Swa. Pool <br /> <br />Other <br /> <br />_Restaurant &: Health Deparblent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COHKERCIAL : <br /> <br />ATTACH (2) PLOI' PI.A5S &: (2) sns OF BUILDIlNIG PLAlNIS &: (1) SET ENERGY FORMS. ** <br />ATTACH (3) SETS OF B1JJTI.DllIG PI.A5S &: (1) SET RlNIERGY FORKS.'H <br />......COPY' OF COlNlTRAC1' REQm:RED. <br /> <br />.. <br /> <br />PE'mfiTS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Tot:al Construction <br /> <br />s <br /> <br />~h <br /> <br />AKP Service Florida Power Corp. <br />~ <br />0<:9,. ::..---- Valuation of Mechanica.l Installation <br /> <br />W.R.E.C. <br /> <br />_ELECl'RICAL <br />Y KECHMUCAL <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFD/lG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCl'IOlNl: _Block <br /> <br />_Fnmle _Steel <br /> <br />Other <br /> <br />FnnSHED FLOOR ELEVATIO~S: <br /> <br />FI' . <br /> <br />IS P.R.OJE:C1' IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />~...~~...~...~~......~~~**~**......*...**~......*...*~~*~*~~~*** <br /> <br />CDl!IIITRACI'OR SECTION <br /> <br />COKPMilY <br />State Cert. or Regist. * <br />City License Registration * <br />~*...*...*~~********...***...~...*~**...~~*...****~**~** <br /> <br />BUILDER <br /> <br />Signat:ure <br /> <br />Sismature <br /> <br />CO!IPAlNIY <br />State Cert. or Regist. * <br />City License Registration I <br />...~*...*...~~**...*...*~~*****...***...*~*~~...*******~*... <br /> <br />ELECl'RICIAN <br /> <br />PLOKBER COKPAlNIY <br />State Cert. or Regist. * <br />Signature City License Registration I <br />...*...~******...****...****...*~*...**...*............*~~****** <br /> <br />KECHANIC.U. ~ COIIPAn /; '" ~v L .a-~ I~~ <br />f3~ /_) J" State Cert. or Reg-u(t. *. 0 () s:-V! ~....... <br />Signature ~{/{ /. It. . City License Registration :f 7/ <br />~"'***"'il:"''''****''''''**~**'''*''''''*~'''*''''''*~~****il:'''** <br /> <br />OIHER. CO'!IPMiJY <br />State Cert. or Regist. * <br />Signature City License Registration i <br />**"'~"'*"'****"'**"'****"'*il:"'*"'**"'*"'~****~~il:~*~* <br /> <br />APPLICATION APPROVED BY <br /> <br />'-II tlMh(J ~ ~ <br /> <br />PERKIT OFFICER. <br />