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<br />APPLICATION FOR PERHIT <br />CITY OF ZEPIIYRIIII.I.S <br />BUILDING DEPAImtENT <br /> <br />L & /U C-I ~ E CL~<--/'t.--g /~C , <br />OWNER'S lWtE I;~fg li~<J -ClftlUi~-'-~6~:T PHONE 78 3 - t5 'f. r () <br /> <br />OWNER'SADDRESS 73 35" ~L 8/-'//0, -#-;2 2~Cff~t'frC.i.q, F,-<-, '3"SS"c/( <br />< <br /> <br />JOB ADDRESS '7 3<{ 9 <br /> <br />&~:.-c._ <br /> <br />L5 0 U L~//T?'L~ <br /> <br />LEGAL DESCJUPl'I.OR: LOT(S) B~SUBDIVISION <br />PARCEL 1. D. t 3 =:: ~ 2.5 - :2 I - 0 0/ 0 ~ (/ 15 ~ 00- () C> 0 I <br /> <br />WORK PROPOSED:_New Construction _Addition _Alteration _Repair _Install <br /> <br />V Sign <br /> <br />_Hove <br /> <br />_De-.olish <br /> <br />PROPOSED USE: <br /> <br />Single Fa.ily <br />Vec-ercial <br /> <br />_H/F <br /> <br />_' of Units <br /> <br />____H/H <br /> <br />_Indust. <br /> <br />____Swt.. Pool <br /> <br />Other <br /> <br />_Restaurant & Health Depar~t Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />~uare Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />cotIKERCIAL : <br /> <br />A'ITACH (2) PLOT PLAliS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />A'ITACII (3) SETS OF BUlLDlliG PLANS & (1) SET ENERGY FORtIS. <br />PROPERTY SURVEY REQUIRED FOR ALL 5I1W CONSTRUcnON. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECI1UGAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />V.R.E.C. <br /> <br />_ltECIIAIO.GAL <br /> <br />$ <br /> <br />Valuation of lIechanica1 Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORS'IKUCI'lON: _Block _Fr~ _Steel <br /> <br />Other <br /> <br />FItUSBED FlOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />F.T.F.CI1UCIAli <br />SiQD~Lure c-ifc~ <br /> <br />;C/) ~~ <br /> <br />COMPARY /l5S0Cfl'/7'?;;:O ~G.(-ct'-n,C/f-<.. S'L-l:l:'VCCcS'" zp..,.c, <br /> <br />StaLe Cert. or Regist. t ESo ".)(}) IrU <br />CiLl' License Registration , <br />****************************************** <br /> <br />PLUMBER <br /> <br />cotIPAIlY <br />State Cert. or Regist. , <br />City License Registration t <br />****************************************** <br /> <br />SignaLure <br /> <br />IfECIIARlGAL <br /> <br />cottPANY <br />StaLe Cert. or Regist. t <br />City License RegisLration , <br />****************************************** <br /> <br />SignaLure <br /> <br />OTRF.R <br /> <br />COMPANY /t!SCJcorl?:Z) t::::Z~?k/c~ g~t/ICcYrJ:;r...e. <br />r: ~ ,/J./ State Cert. or Regist. t c::-5 0000 /10 <br />{fl~- P".---e-<A/f. City License RegistraUon , <br />*****************************-************ <br /> <br />Signature <br /> <br />APPLICATION APPKOVED BY <br /> <br />PERllI.T OFFICER. <br />