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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRIIILLS <br />BlJfILDUJG DEPAR'I1IIENT <br /> <br />OWER'S NAKEJ (~Y\t-D ~ . ~6NN5J) ~ <br />OWER'S ADDRESS LI4}Z}' ,....16' .If." y--- <br />t..f1z ~ 14 f.k ";>--+. <br /> <br />tf73Z-S"" <br /> <br />mmm <br /> <br />/1~ ~. <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPl'ION: WI'(S) <br /> <br />BI...OCK <br /> <br />SllBDIVISIOJil <br /> <br />PARCEL I. D. # <br /> <br />14-2-G,..-21 -ooto --02'500- 0070 <br /> <br />/ <br /> <br /> <br />~epair <br /> <br />_Install <br /> <br />t<<lRK PROPOSED:_Mrew Construction _Addition _Alteration <br /> <br />_Sign <br /> <br />_!!love <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />~ingle <br /> <br />Faaily <br /> <br />_KIF <br /> <br />_, of Units <br /> <br />_H/H <br /> <br />_~rcial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Rest:aurant &: Health Depart:aent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COHHERCIAL : <br /> <br />ATTACH (2) PLOI' l'LARS &: (2) SEI'S OF BlITLDIJilG PLUlS &: (1) SET ElffiRGY FORHS.** <br />ATTACH (J) SE'I"S OF BllJILDDilG l'LARS &: (1) SET ENERGY FORKS. .u. <br />......COpy OF CONTRACT REQUfRED. <br /> <br />~LDIRG <br /> <br />PERKITS REQUESTED <br /> <br />$ <br /> <br />IS;o , 00 <br />1 <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_HECHMfiCAL <br /> <br />s <br /> <br />Valuation of Mechanical. Installation <br /> <br />_PUJHBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION!: _Block <br /> <br />_FraBle _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PROJECT Hi FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />..............................*****...****............*... *...*................................. * * <br /> <br />CONlTRACTOR SECTION <br /> <br />BUILDER COI!fPAHY 0 Wf\J E~ . <br />State Cert. or Regist. I <br />Signature City License Registration I <br />**.........*...****...*...*************************...** <br /> <br />ELECTRICIAJi COIIPANY <br />State CerL or RegisL I <br />Si~ture City License Registration , <br />**...**.........***********************...*...**...***** <br /> <br />PLmtBER COI!tPAln <br />State Cert. or Regist. , <br />Signature City License Registration I <br />**************************************......** <br /> <br />HECHAlfiCAL COI!tPABY <br />State Cert. or Regist. I <br />Signature City License Registration I <br />*****...************...*****...**************...** <br /> <br />0'l'BER. COI!fPANY <br />State Cert. or Regist. I <br />Signature City License Registration , <br />***...***...****.*******......****..........************ <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br />