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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRIIIJ..LCj <br />BUILDING DEPARnIEN'T <br /> <br />C-/4I/ /(/E-/~ >. . <br />Q vdy ~ l%-..emfE-f'tJ/rT <br />r;~p-- /J;;<? <br /> <br />" -~ <br /> <br />OWNER'S lWtE 2 EP) v f( A; ) k j{//ffER. <br /> <br />r / <br /> <br />OWNER'S ADDRESS 7 7>7 fJ{/I/V~PI 4C/ E. <br />L/JJcJ ;JoT{ ST, <br /> <br />CO/?,// <br /> <br />. <br /> <br />PHONE 78?J-/YS-Y; <br />G-1'fEE/l/W Ie ( ) C-I O??J'O <br /> <br />~ <br /> <br />.2 E~/; YRh(~ lis ?"C / J J ...sSLc;1 <br /> <br />, / <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPl'ION: I.OT(S) <br />PARCEL LD.' SF C 11t7~ <br /> <br />BLOCK <br /> <br />SUBDIVISION <br />R9E <br /> <br />/3 I <br /> <br />IN? d~ Sf <br /> <br />- <br /> <br />:;;< / }: <br /> <br />WORK PROPOSED:_Nev Construction _Addition -6.Alteration ~pair _Install <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: Single Faaily <br />~ercia1 <br /> <br />_H/F <br /> <br />_, of Units <br /> <br />_H/H <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Restaurant &: Health DepartJlent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COtDtERCIAL : <br /> <br />ATTACH (2) PLOT PI..AliS &: (2) SETS OF BUIIJ>IBG PLANS &: (1) SE'l' ENERGY FORKS. <br />ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORIIS. <br />PROPERTY SURVEY REQ1ITRIID FOR ALL NEW CONSTRUC'l'ION. <br /> <br />PERKITS REOIJ&CiTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />s% CfC <br />, <br /> <br />Valuation of Total Construction <br /> <br />_ELECI'RICAL <br /> <br />.AKP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECllMlICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Inst:a11ation <br /> <br />_PLUHRING <br /> <br />GAS <br /> <br />ROOFlliG <br /> <br />SPECIALTY <br /> <br />TYPE OF CONS'I'RUCI'IOB: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />Fr. <br /> <br />IS PROJECl" III FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRAcroR SEC'l'ION <br /> <br />BUILDER ~~ COIIPAIIY A '&mER~S {Otf/$.-IRCI~'';;'(;71/J <br />( ~~ State Cert. or Regist. . COOS-.;2 <br />Signatur . City License Registration , "":.:J ::;2- <br />***************************************** <br /> <br />~ <br /> <br />ELECI'RICIAN 3J. - GOttPANY J,N 'I E7LL OC( c )...::1. "-.-CT A ( c... <br /><- State Cert. or Regist.' ~A..Oo /00'11 <br />Si~ture~. ~ City License Registration. dl619 <br />**************~************************** <br /> <br />PLUHBER <br /> <br />COIIPARY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />Signature <br /> <br />MECllANICAL <br /> <br />cottPABY <br />State Cert. or Regist. , <br />City License Registration t <br />****************************************** <br /> <br />Signature <br /> <br />m1IF.R . <br /> <br />COIIPANY <br />State Cert. or Regist. , <br />City License Registration f <br />****************************************** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERllIT OFFICER. <br />