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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRIIII.L<<i <br />BUILDING DEPAImIKNT <br /> <br />OWNER' S RAIlE /('f/ I L c.. I ~ <br />OWNER'S 'ADDRESS~s- '/ ') Y <br />JOB ADDRESS ~ <br />, <br /> <br />~,Ii? Cc----J <br />tP <br />10Th'" 51 <br /> <br />PHONE <br /> <br />7 f ~ D I' 5"6 <br /> <br />LEGAL DESCRIPrlON: LOT(S) <br /> <br />BWGK <br /> <br />SUBDIVISION <br /> <br />PARCEL 1.0.' <br /> <br />WORK PROPOSED:~Nev Construction _Addition _Alteration _Repair --K.Install <br /> <br /> _Sign _Hove _DeIIOlish <br />PROPOSED USE: X Single Faaily _"/F _' of Units _"/H <br /> _~rcial _Indust. _Swia. Pool ;-Cr>/( 6~ Other <br /> <br />_Restaurant&: Health Depar~t Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />~e Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COftKERCL\L : <br /> <br />ATtACH (2) PLOT PLAI!DS &: (2) SEI'S OF BUlIDING PLANS &: (1) SET ENERGY FORMS. <br />AtTACH (3) SEI'S OF BUILDIBG PLANS &: (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL liEW CONSTRUC'l'ION. <br /> <br />PERIlITS REQUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Tot:al Construction <br /> <br />_ELECl'RICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />V.R.E.G. <br /> <br />_ttECIIANICAL <br /> <br />$ <br /> <br />Valuation of lIecbanical Insta1lation <br /> <br />_PLOfIBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSmDCrlON: _Mock _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FI' . <br /> <br />IS PRWECr IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CORTRAcroR SEC'ITON <br /> <br />BUILDER <br /> <br />GOttPAIIY <br />State Cert:. or Regist:. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />F.T.F.CIRICIAN <br /> <br />COHPANY <br />State Cert:. or Regist:. , <br />City License Registration . <br />.......................................... <br /> <br />SiPJl:llture <br /> <br />PLUKBER. <br /> <br />COHPANY <br />State Cert. or Regist. , <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />IlECBANlCAL <br /> <br />COHPAIiY <br />State Cert. or Regist:. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />OTRF.R . <br /> <br />A <br />I <br /> <br />/V7 <br /> <br />COHPARY ? e~ y.L r-e-/I.---" c. ~ <br />':-:> State Cert. or Regist:. . <br />r -~ _City License Registration . z:: ~ <br />.......................................... <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />I'ERllIT OFFICER. <br />