Laserfiche WebLink
<br />APPLICATlOR FOR PERllIT <br />CITY OF ZEPIIYKIIILLS <br />BUILDIBG DEPARnIERT <br /> <br />OWNER'S lWtE Wll'\4-er3 f\\ U. p. <br /> <br />mORE <br /> <br />OWRER'S ADDRESS <br /> <br />JOB ADDRESS 3 'ED 4~ \ dd \"e- 'A l) e.... <br /> <br />LEGAL DESCRIPl'IOR: LOT(S) <br /> <br />BWCK <br /> <br />SUBDIVISIOR <br /> <br />PARCEL LD.' <br /> <br />WORK PROPOSED:_Rev Construction _Addi t. ion _Alt.erat.ion _Repair _Install <br /> _Sign _Hove _DeJIOlish <br />PROPOSED USE: Single Fallily --1f/F _, of Unit.s _HIH <br /> _ec:-ercial _Indust. . _Swia. Pool Other <br /> <br />_Restaurant &: Health Depart.llent Approval <br /> <br />BUILDIBG SIZE: <br /> <br />x <br /> <br />~e Feet., <br /> <br />Height. <br /> <br />RESIDERTIAL: <br />cotIHER.CIAL : <br /> <br />An'ACB (2) PLOT PLUS &: (2) SETS OF BUlLDIBG PLARS &: (1) SEl' ERERGY FORMS. <br />An'ACB (3) SETS OF BUILDDiG PLANS &: (1) SEl' ERERGY FOBIIS. <br />PROPERTY SURVEY RIlQUIBED FOR ALL IiIJ.V mRSmUC'fIOR. <br /> <br />PERKITS REOUESTED <br /> <br />~DILDIRG <br /> <br />$ <br /> <br />7DD .0"0 <br /> <br />Valuat.ion of Total Construction <br /> <br />_ELEC11UCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_HECllARICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLmtBIRG GAS ROOFlRG <br /> <br />SPECIALTY <br /> <br />TYPE OF mRSTRUCl'IOR: _Block _Fralle _St.eel <br /> <br />Other <br /> <br />FIRISHED FLOOR ELEVATIORS: <br /> <br />FT. <br /> <br />IS PRO.JECI' IB FLOOD ZORE AREA? <br /> <br />YES RO <br /> <br />.......................................... <br /> <br />BUILDER <br /> <br />CONTRAGroR SECJ'IOR <br /> <br />COlfPAliY 7]+;1 rrJ/i5z)NI?f.~n7('On+ .lA/C!-, <br />/J~A'> :,/? ,'-.A,? /.'" _ Stat.e Cert.. or Regist. , <br />J!i~ ~k... = Cit.y License Registrat.ion' l/ 'I <br />.......................................... <br /> <br />Signat.ure <br /> <br />F.I.F.C11UCIAII <br /> <br />cotIPARY <br />Stat.e Cert. or Regist. , <br />Cit.y License Regist.rat.ion , <br />.......................................... <br /> <br />Silnl~t.ure <br /> <br />PLUHBER <br /> <br />cotIPANY <br />S tat.e Cert.. or Regis t. I <br />Cit.y License Regist.rat.ion , <br />.......................................... <br /> <br />Signat.ure <br /> <br />HECllARICAL <br /> <br />cotIPAliY <br />Stat.e Cert. or Regist. , <br />Cit.y License Registration , <br />.......................................... <br /> <br />Signat.ure <br /> <br />OTRF.R . <br /> <br />cotIPAliY <br />Stat.e Cert.. or Regist.. , <br />Cit.y License Regist.rat.ion , <br />.......................................... <br /> <br />Signature <br /> <br />APPLlCATIOR APPROVED BY <br /> <br />PERtlIT OFFICER. <br />