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<br />~,:.~, . 'if . <br /> <br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYKIIILLS <br />BUILDING DEPAR1ItENT <br /> <br />OWNER" S IWtE On u 5' ftG D D ( /YifLAAJ PHONE 7~ - 8D ;;).,j <br />OWNER"S ADDRESS .53 if 61-/. S#, <br />JOB ADDRESS 53 ~ I ~fi S~ <br />LEGAL DESCRIPl'IOIi: LOT(S)~ of I...;l B~SUBDIVISION <br />PARCEL I.D.' 11- 2~-2/- ~ 0(0- 1.2 cfo::> - 00/0 <br /> <br />WORK PROPOSED:~liew Construct.ion _Addition _Alteration _Repair ~Install <br /> <br />_Sign <br /> <br />_Move <br /> <br />_ne.olish <br /> <br />PROPOSED USE: ()( Single Fallily <br /> <br />_H/F <br /> <br />_' of Units <br /> <br />_H/H <br /> <br />_~rcia1 <br /> <br />_Indust. . <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Restaurant 5: Hea1th Depart:aent. Approval <br /> <br />BUILDIBG SIZE: <br /> <br />&' X 10 , <br /> <br />'7't <br /> <br />Square Feet, ,g7 1/5? <br /> <br />Height <br /> <br />RESIDENTIAL : <br />COHKKRCIAL : <br /> <br />AtTACH (2) PLOI' PI.MlS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />AtTAGII (3) SE'lS OF BUILDING PLANS & (1) SET ENERGY FORtIS. <br />PROPERTY SURVEY JUlQUIBIID FOR ALL REW WNSTRUCTION. <br /> <br />PERKlTS REDUESTED <br /> <br />K-BUlLDIRG <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_HECBANICM. <br /> <br />$ <br /> <br />Valuation of Mechanical Inst.allation <br /> <br />_PLUHBIliG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCfION: _B1ock _Fr~ _Steel <br /> <br />;Y' <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 />CONTRACI'OR SECI'lON <br /> <br />BUILDER <br /> <br />Signature <br /> <br />.JV1y 5,; f F <br /> <br />COHPARY <br />State Cert.. or Regist. , <br />City License Registration t <br />.......................................... <br /> <br />ELECTRICIAN <br /> <br />COHPARY <br />A A 1 f If State Cert. or Regist. t <br />/ VI f 5 G- fo U NrlNf.t City License Registration t <br />...1...................................... <br /> <br />Si-t.ure <br /> <br />PLUMBER <br /> <br />COMPANY <br />JV\ t ~ b t State Cert. or Regist. , <br />5 {::... (I /lID A/I" Cit.)~ License Registration , <br />)I .. ....................................... <br /> <br />Signature <br /> <br />HECHAliICAL COHPARY <br /> <br />M fJ::: I J- Stat.e Cert. or Regist. , <br />Signature y S ~I..L.---b..1LI /VOAJI;C City License Registrat.ion t <br />.......................................... <br /> <br />OTHER <br /> <br />Signature- <br /> <br />COKPANY <br />11~ 1).() Sta<e CerL or Regis<. . <br />M ~ N~~i(LJ./ City License Regist.ration , <br />.......................................... <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OFFICER. <br />