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<br />. <br /> <br />~,~ <br /> <br />""'....---:,,-.-:,... <br /> <br />APPLICATION FOR PElUtIT <br />GI'IY OF ZEPBYImII.LS <br />B1lJII.DIRG DEPARnIEm" <br /> <br />0l.,"NER · S BAKE <br /> <br />BA-J2.bAM 'S I ~ ~bb <br />J4J4 I hTn '7>1- 2..tr.ph'1"J.,; lls <br /> <br />PHONE t"J <it )- - /05> () <br />'$ 3~4b <br /> <br />OWNER'S ADDRESS <br /> <br />t]A. <br /> <br />.JOB ADDRESS t;;~z- <br />LEGAL DESCRIPTION: LOT(S) ;)~... /;.. ~ \ <br /> <br />BIDCK 41 <br /> <br />SUBDIVISIOII <br /> <br />PARCEL L D. t <br /> <br />WORK PROPOSED:_lNIew Construction ~Addition _LAlteration _Repair _Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />~ Single Faaily <br />, <br /> <br />___"IF <br /> <br />_, of Units <br /> <br />---"IH <br /> <br />_~rcia1 <br /> <br />_Indust. <br /> <br />_Swi:a. Pool <br /> <br />Other <br /> <br />_Restaurant &: Hea11:h ~t Approval <br /> <br />j I <br />BUILDDiG SIZE: 12. X 15" . <br /> <br />300 <br /> <br />Square Feet. <br /> <br /><;II <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COItKKRCIAL : <br /> <br />ATI'ACH (2) PI.OT PJ:..AIIS &: (2) SEI'S OF BUILlHBG PI..UlS &: (1) SET ENERGY FORMS.** <br />ATI'ACH (3) SEI'S OF BUllDIRG PLUlS &: (1) SET ENERGY FORKS. ** <br />**COPl' OF CORl'RAcr ~tl!IRIlD. <br /> <br />--LBUILDING <br />1ELECTRICAL <br /> <br />ttt<O <br />$ {, (:;00 Valuation of Total Construction <br /> <br />_I,;}, ~ AKP Service \/'" Florida Power COrp. <br /> <br />PERKT'T'S REOUESTED <br /> <br />W.R.E.C. <br /> <br />~CAL <br />I" PLUKBING <br /> <br />$ <br /> <br />lIaluat:io.Jr. of Kechanica1 Installation <br /> <br />GAS <br /> <br />_____.dOOFHiG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTIOlNl: _Block ~,Fraae _Steel <br /> <br />.. <br /> <br />Other <br /> <br />YES <br /> <br />~ <br />NO <br /> <br />FlliISBED FLOOR ELF.VArrO~5: <br /> <br />~,. <br /> <br />"".j .d",jll;~T 1Il'II }t'LOOD ZONE AREA? <br /> <br />***********.****************************** <br /> <br />OOW'.tRACI'Oi?, SECTION <br /> <br /> <br />COItPiiW.t <br />St:ate Cert. or Regist. # <br />City l~icense Registration I <br />************;0". .......****"'~ ..******************* <br /> <br /> <br />ELECTRItIAN <br />SiPn#llture ~j'~L::> <br />, <br />PLUKBER. cL' .... IDIPARY C./(((/-5 j2AIt~ {;JJfmb,)J6 <br />. ~ 0 i2 If State C'.ert. or Regist. , t-or::Y II <br />Signature '.r61 .ZJ / ~~ City License Registration # S 7 . <br />*********************;::*-****************** <br /> <br />CO!W;~Y <br />e ' State Cert. or Regist. i- C'I( .w 7 s ~ S <br /># '71f~- City License Registration , <br />******._**************...****************** <br /> <br />MECHARICAL <br />Signature~~ ::: <br /> <br />I .. <br /> <br />1DIPM'I~~m '~ <br />Stat:e Cert. or Regist. - ~ :..~ <br />i'f"~'" - CHy License BegisttaU";; :., ~ <br />** *********.::.. <r*"*****i':.a-******************* <br /> <br />O'T'IIRR <br /> <br />~. ,~--- ----.------- <br />Stc:;~,- Gert. or Regis!.. I <br />_ ,;H:.:;r License Registration I <br />*********"'****,,,,'-'c.. ...**--*....******************** <br /> <br />Signat:w:'e <br /> <br />APPLICAi'ION APPROVED BY <br /> <br />PERKIT OIlY!:GER. <br />