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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME <br /> <br />ChiDe 5 c.-udde 12- <br />63d-Y t/+~ St <br />d rJd "5-L <br /> <br />PHONE 7~~ - J fo~3 <br />2eFh'ji2-~: 1\5; FL .3 3s-tJD <br />2-~t) h ~ f2-h: J (~) F { ~. 3' 3 ~-y L <br />SUBDIVISIOIf <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />5d'd (p <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL I.D.' <br />WORK PROPOSED: New Construction _Addition _Alteration -.'L.Repair _Install <br /> <br />BLOCK <br /> <br />_Sign <br /> <br />Move <br /> <br />_DeIIOlish <br /> <br />PROPOSED USE: <br /> <br />Single Family <br /> <br />_M/F <br /> <br />_, of Units <br /> <br />_M/B <br /> <br />_Commercial <br /> <br />Indust. _Swill. Pool <br /> <br />Other <br /> <br />_Restaurant &: Health Department Approval <br /> <br />BUILDING SIZE: dO x....!i.J2, <br /> <br />"8" cc;:; <br /> <br />Square Feet, <br /> <br />/'0 <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 />-t-BUILDING <br />LELECTRlCAL <br />_MECHANICAL <br />PLUMBING <br /> <br />$ <br /> <br />9' OtX:) q9 Valuation of Total Construction <br />AMP Service Florida Power Corp. <br /> <br />_V.R.E.C. <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: -t-BloCk _Frue _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />****************************************** <br /> <br />YES NO <br /> <br />BUILDER <br /> <br />COIfTRACTOR SECTION <br /> <br />~ ClIIPAIIY /lAa.-j! CotU?/n-J./c---r;'bAJ <br />State Cert. or Regist.' (oj!> C. DS-~-~~ <br />City License Registration , <br />********* ******************************** <br /> <br />Signature <br /> <br /> <br />J <br /> <br />COMPANY ;l4wK,'fV.s J3't-ec;-/ /2-;C,4 L- <br />State Cert. or Regist. , ~ <br />City License Registration' <br />************************** <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License RegistratioD . <br />****************************************** <br /> <br />!meBANlCAL COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration' <br />****************************************** <br /> <br />:n'BER COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration' <br />****************************************** <br /> <br />lPPLICATION APPROVED BY PERMIT OFFICER. <br />