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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME <br /> <br />))01 TIfIE- Ou-r PHONE 7S3 ;2.93S" <br />7~ 32- O~c6/? C~ <br />#L.fJ /1'/1 J//U'l6 ~ <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL loD.' '3 &,;J-.~ ;L{ <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />4Jr 7/ <br /> <br />p~ If <br /> <br />pt s- t1~~-CJ <br />W II <br /> <br />WORK PROPOSED: ~New Construction _Addition _Alteration _Repair ~Install <br /> <br />_Sign <br /> <br />Move <br /> <br />_Demolish <br /> <br />PROPOSED USE: <br /> <br />Single Family <br /> <br />_M/F <br /> <br />_' of Units <br /> <br />_M/H <br /> <br />Commercial <br /> <br />Indust. Swim. Pool <br /> <br />Other <br /> <br />BUILDING SIZE: <br /> <br />____Restaurant &: Health Department Approval <br />17' X :?3, AoL- r:#G~' Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. ** <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. ** <br />**COPY OF CONTRACT REQUIRED. <br /> <br />PERMITS REQUESTED <br /> <br />BUILDING <br /> <br />$ <br /> <br />'1"",\ .r-"1J"{) <br />o'-~ lu <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 />MECHANICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: Block Frame Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />BUILDER <br /> <br />CONTRACTOR SECTION <br /> <br />COMPANY ::::UAl5'~ <br />~~ State Cert. or Regist. , <br />~ City License Registration , <br />****************************************** <br /> <br />~rJl1P1/cI~ <br />/7. <br /> <br />Signature <br /> <br />ELECTRICIAN COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration' <br />****************************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration # <br />****************************************** <br /> <br />MECHANICAL COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration' <br />****************************************** <br /> <br />OTHER COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration' <br />*************************************~**** <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />