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<br />APPLICATIOR FOR ~T <br />CITY OF ZEPllYRHIu.5 <br />Bm::LDUiG DEP.AR'I1!IERT <br /> <br /> <br />OWNER'S RAKE <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS .S A m ~ <br /># t""c <br />LEGAL DESCRIPTION: UJI'(S) ~ L <br /> <br />PRO~ <br /> <br />7~Y- (..{~D <br /> <br />1'- L-S <br /> <br /> <br />BI..OCK: <br /> <br />SlDBDIVISIOIN1 <br /> <br />s.J;Jscr eS'/A-J€ sf <br /> <br />PARCEL I. D .:f <br />WORK PROPOSED:_!8lew Construction X. Addition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_l!fove <br /> <br />PROPOSED USE: x.. Single Faai.ly <br /> <br />_KIF <br /> <br />_Indust. <br /> <br />_~rcia1 <br /> <br />_Deao.lish <br /> <br />_, of Units <br /> <br />_M/B <br /> <br />_S~. Pool <br /> <br />Other <br /> <br />!:J~' II 51'" <br />BUlLDIRG SIZE:.:1..) 8' X.:J r go , <br /> <br />/.3 Cl, 5 <br /> <br />_Restaurant & Hea1th ))eparmIent Approva1 <br /> <br />Square Feet. <br /> <br />/ :3 Il It <br /> <br />Height -;; fl4'~ <br /> <br />RESIDENTIAL : <br />COHftERCIAL : <br /> <br />A'ITACH (2) PI.OI' PLMiS &; (2) SEIS OF BUILDING PLMilS & (1) S:E::T ENERGY FORMS. ** <br />ATTACH (3) SETS OF BUlLDDlG PLMiS & (1) S:E::T ENERGY FORKS. t* <br />tt(X)PY OF COIN1TRACT RIlQ1JJIRED. <br /> <br />Y BUILDING <br />~ELECTRICAL <br />~HECHANICAL <br />~PLmmIBG <br /> <br />.; <br />/:>cC.oO <br /> <br />$ <br /> <br />AKP Service <br /> <br />s <br /> <br />J 7~3. tf r <br /> <br />GAS <br /> <br />TYPE OF (x)NSTRUCTIO~: ~Block _Fraae _Stee1 <br /> <br />')( <br /> <br />FII!fiSBED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />PERKITS REQUlESTIID <br /> <br />Va1uation of Tot:a.l Construction <br /> <br />F10rida Power Corp. <br /> <br />W.R.E.C. <br /> <br />Va1uation of Hechanica.l Inst:allation <br /> <br />)L- <br /> <br />SPECIALTY <br /> <br />ROOFlliG <br /> <br />Other <br /> <br />IS PROJECT IN FLOOD ZONE ARE..<\? <br /> <br />tttttttttttttttttttttttt*ttttttttttttttt** <br /> <br />YES NO <br /> <br />(X)~croR SECTION <br /> <br />Signature <br /> <br />CO!IPMIIY <br />State Cert. or Regist:. 41 <br />City License Registration , <br />tttttttt*t~ttt***tttttttt*tttttt*tttt*t <br /> <br />BUILDER <br /> <br />Si <br /> <br /> <br />CO!IPAH f(~+ C(~Sb ~('e;f <br /> <br />State Cert:. or Regist:. j.} Od (( ?f ~ <br />City License Registration I I"~ <br />ttttt**t***t*****t*t*t**ttttt*t*ttttt <br /> <br />ELE <br /> <br />PLUKBER <br /> <br />~r!? <br /> <br />CO!IPANY D1..1';; C!.i'Mcfi fi 11M P,,.J6 S~t.JIe..6' <br />St:ate Cert. or Regist:. 41 IlF DO CoI ~ 19 <br />City License Registration I " . r~ ~ <br />- <br />*ttttttt*ttttt*t****t**tt*t* *tttt*tttttt <br /> <br />S ignat:ure <br /> <br />KECHAlUCAL <br />Signa~' <br /> <br /> <br /> <br />CO!IPANY <br />St:ate Cert. or gist. I <br />City License Registration <br />tttttttttt*tttttttttt*tttt*** <br /> <br />Signature <br /> <br />CO!IPAJIY <br />St:ate Cert:. <br />City License Registration <br />t**ttttt*tttt**ttt*t*tttt*tt***t* <br /> <br /> <br />O'T'HF.R <br /> <br />APPLICATION APPROVID BY )1 ~ J _ >I!I ,;/JAI'vJ <br /> <br />PERKIT OFFICER. <br />