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<br />~c:':~~__'-~'''''''''''''''''''''''''''_-'Cc'''----'-- - - ---- _ <br /> <br />APPLICATI:OIiI FOR PERMIT <br />CI'IY OF ZEPJIYRIlILLS <br />BUILDIIiIG DltPAR1'HE'NT <br /> <br />OWNER · S MAKE <br /> <br />fl. tJ.. .s'ezMAAf <br /> <br />\\ . <br />t:~AFE J.-/T;C /1 <br /> <br />PIIONE 8-/s -7~3 -(,b 7-1- <br /> <br />OWNER · S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />~~/~ Ai.. ~IIISII~ ) <br /> <br />LEC.AL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1. D. # <br /> <br />WRK PROPOSED:_l!l.!eW' Construction ---P\ddition _Alteration _Repair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: <br /> <br />Single FaDlily <br /> <br />_KIF <br /> <br />_' of Units <br /> <br />_H/H <br /> <br />_Co.aercial <br /> <br />_Indust. <br /> <br />_Swi.. Pool <br /> <br />. Other <br /> <br />_Restaurant Ii: llealth Deparblent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COtIHERCIAL : <br /> <br />ATTACfI (2) PLOT PI.ANS Ii:: (2) SEI'S OF BUILDING PLMilS &: (1) SET ENERGY FORHS.** <br />A'ITAClI (3) SETS OF BlJILDDG PI.ANS Ii: (1) SET ENERGY FORMS. ** <br />"''''COPY" OF CONTRACT RE.Qmmm. <br /> <br />PERnITS REOUF_"iTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />,,0 <br />x4/}' <br /> <br />Va1uation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power COrp. <br /> <br />W.R.E.C. <br /> <br />_MECHANICAL <br /> <br />$ <br /> <br />Va1uation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCI'IOIN1: _Block. <br /> <br />_Fr3llle _~eel <br /> <br />Other <br /> <br />FINISHED FLOOR EI.EVATIm~S: <br /> <br />FT. <br /> <br />IS P.ROJECT IN FLOOD ZONE ARE...\? <br /> <br />l"'ES NO <br /> <br />"'''''''''''''''''''''''''''''''''''''''''''*******************'''******* <br /> <br />CONTRACTOR SECTION <br /> <br />RUILDY.R <br /> <br />Signature <br /> <br />COIIfPMlIY <br />State Cert:. or Regist:. i# <br />City License Registration # <br />****************************************** <br /> <br />EI.ECTRIClAN <br /> <br />CO'!IPANY <br />State Cert:. or Regist:. #i= <br />City License Registration f <br />****************************************** <br /> <br />Sirolature <br /> <br />PLUKRER <br /> <br />COHPANY <br />State Cert. or Regist. #f: <br />City 1,icense Registration f <br />*******"'********************************** <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />CO'!IPANY <br />State Cert. or Regist. , <br />City License Registration B <br />****************************************** <br /> <br />OTHER. <br /> <br /> <br />l' <br /> <br />CO'!IPANY ~/61iS <br />State Cert_ or Regist. i# <br />City License Registration i# <br />.............*............................ <br /> <br /> <br />PERHIT OFFICER. <br />