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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRIIILLS <br />BUILDING DEPAR'IKENT <br /> <br />OWNER' S BAttE f}J ft- (5 c L- C"C;.!/cfl.,,-Y PHONE iF-z. 1fl-.3u <br /> " <br /> " '"? tt oj"]. ~-f!I- ;hk .-- 2 ~ tf7 tj:..f, I let J Ls-t.-to <br />OWNER'S ADDRESS <br /> -..3 Ihfr'l ~ ;?S' .ff{[J tr6' <br /> " <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />WORK PROPOSED:_New Construct.ion _Addition _Alteration ~pair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_DeJI01ish <br /> <br />PROPOSED USE: ~ing1e Falin,. <br /> <br />_H/F <br /> <br />_' of Units <br /> <br />_H/B <br /> <br />_~rcia1 <br /> <br />_Indust. <br /> <br />_Swia. Poo1 <br /> <br />Other <br /> <br />_Restaurant &: Hea1th Depart.8ent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />~re Feet, <br /> <br />Beight <br /> <br />RESIDENTIAL: <br />cotIKERCIAL : <br /> <br />ATTACH (2) PLOT PLAJilS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NIl.W CONSTRUC'fION. <br /> <br />PERtUTS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Va1uaUon of Total Construction <br /> <br />_ELECl'JUGAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_ttECHAInGAL <br /> <br />$ <br /> <br />Valuation of Hechanical Inst:a11ation <br /> <br />_PLlJ.mUIG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fralle _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 />S. ./ <br />19nature <br />l- <br /> <br />CONTRActOR SECI'ION <br /> <br />" /, / COftPAIIiY friL ~-(' J1..i C.4J-.'(/ <::o~' ce-- <br />Ii 7 /'7f-d'. State Cert. or Regist.. t c&- c. 0 ! G:, Cj t...f () <br />t/~..t#L0 , //~, ~ City License Registration t ...J '" :3 <br />***************************************** <br /> <br />ELEG'TRI.CIAB <br /> <br />SiPlUlture <br /> <br />~/llr <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />PLUKBER <br /> <br />Signature <br /> <br />;t/ / t,1 <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />flECllANICAL <br /> <br />Signature <br /> <br />cottPANY <br />~' State Cert. or Regist. , <br />,/t/ 'If City License Registration t <br />, ****************************************** <br /> <br />OTRF.R <br /> <br />Signature <br /> <br />FAD- <br /> <br />COKPANY <br />State Cert. or Regist. , <br />City Licens~Registration t <br />****************************j*********.*** <br />~ ' <br /> <br />APPLICATIofI,APPKDVED BY <br /> <br />'~ <br />r <br /> <br />PERinT OFfICER. <br />