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<br />APPLICATIOIl FOR PERHIT <br />CITY OF ZEPIIYRIIllLS <br />BUILDING DEPAR1'HRlNIT <br /> <br />OWNER'S BAKE IJ1 If -t rn. R5 $ Lv e!US 7:) IV <br />OWNER'S ADDRESS c:. ;Q I 0 ~ e IV e::.-7T <br />JOB ADDRESS S Il m ,t; <br /> <br />PHOlNlE ~ gg -- _5/ Zi? <br /> <br />LEGAL DESC'RIPl'I01!il: LOI'(S) <br /> <br />JlLOC.'K <br /> <br />SUBDIVISIOlNl <br /> <br />PARCEL I. D. f <br /> <br />WORK PROPOSED:_lIev Construction -XMdi.tion _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single F3IIIily <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_M/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swa. Pool <br /> <br />Other <br /> <br />_Restaurant &: Health Depar-=-ent 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) SEIS OF BUILDIIlG PIAlNIS &: (1) SI::I' ENERGY FORMS. *... <br />ATTACH (3) SETS OF B1JJTI.DDlG PIA1!iIS &: (1) SET RlNIERGY FORKS.*':!' <br />......COPY' OF COlNlTRAC1' REQm:RED. <br /> <br />.,. <br /> <br />PEmlITS REQUESTED <br /> <br />XBUILDING <br /> <br />$ <br /> <br />/dOO <br /> <br />Valuation of Tot:al Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_HECHANICAL <br /> <br />s <br /> <br />Valuation of Mechanical. Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCl'IOlNl: _Block <br /> <br />_FraIIie _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIOJWS: <br /> <br />F'I' . <br /> <br />IS P.RO.JJJ:C1' IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />~...**...*****...*****...*......***......*......**......*******......* <br /> <br />COJfiJTRACI'OR SECTION <br /> <br />BUILDER <br /> <br />/nbfw W~ <br /> <br />cmlPAMY )J1: !<:'e W ~ II J ,4 j..-rt S <br />State Cert. or Regist. # <br />City License Registrat.ion , <br />...**...*.........*********~*...*~*...~*.........*......*******...** <br /> <br />(! ?J/V s7/e<J <.. T;Qr.. <br /> <br />..:15 ~ <br /> <br />Signature <br /> <br />ELECTRICIAN OOOIPABY <br />State Cert:. or Regist:. #f: <br />Si~ture City License Registration I <br />********~*****************...****...********** <br /> <br />PWttBER COl!IPAlNIY <br />State Cert. or Regist. #f: <br />Signature City License Registration I <br />******......**...*********...***...**...*......*...*......*...**...* <br /> <br />MECHANICAL COl!IPAlNIY <br />State Cert. or Regist. , <br />Signature City License Registration I <br />.........***......**...***...*********...**...*......*********** <br /> <br />0'1'1IRR CDKPABY <br />State Cert. or Regist. , <br />Signature City License Registratfon I <br />*~*...*************...****...*...***...***...*****...** <br /> <br />APPLICATION APPROVED BY PERHIT OFFICER. <br />