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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPIIYIUIILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME ;4 et'l cl.<.. S 7 -<... <br /> <br />CrC"rPM~ <br /> <br />PHONE <br /> <br />OWNER'S ADDRESS <br /> <br />JOB ADDRESS S.2. 4/ <br /> <br />/h,v If 't 1i,...J' <br /> <br />- <br /> <br />$) <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BWCK <br /> <br />SUBDIVISION $,' flAJ'1' R-<..s'T ftf J tI ~ <br /> <br />PARCEL 1.D.' JU-:2.. (.. ~<-I _06/0 -09;::100 .-dood <br />< <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:_New Construction ~ddition _Alteration <br /> <br />_Repair _Install <br /> <br /> _Sign _Move _Deaolish <br /> , <br />PROPOSED USE: _Single Faaily _KIF _, of Units VK/H <br /> _eo..ercial _Indust. _Swia. Pool _Other <br /> _Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br />BUILDING SIZE: I ~ X SA . C)... Cj <br /> <br />'I, <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />t:. . c~r-(r <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AItP Service <br /> <br />--Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_MECHAlfICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUMBING <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: _Block _Fraae _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 />PLUMBER <br /> <br /> <br />CONTRACTOR SECTION <br /> <br />. ~~/ll =~rr~~fr7'tls <br />GJ~tJ~ a City License Registration' 77 <br />* . *************************************** <br /> <br />~ COMPANY eel tf- J eJ ~ d ~)~ E h~ tt-? <br />~ ! State Cert. or Regist. # <br />~ - City License Registration . ~ ~ <br />*** ************************************* <br /> <br />COMPANY ~q 11-- d~ (r~~ ~/p{;-~ <br />State Cert. or Regist.' . <br />City License Registration . <br />****.********************.************* <br /> <br />BITJI.DER <br /> <br />Signature <br /> <br />="~AA~J <br /> <br />Signature <br /> <br /> <br />J MECHANICAL <br />{\ Signature <br /> <br />.?? <br /> <br />COMPANY ~Af.l1t ~ fio~A'''L e:.;A~ e...~~ <br />State Cert. or Regist'.. 7(1 <br />City License Registration , c:. At:: 0 <of ~ ~ Y Ii> <br />****************************************** <br /> <br />OTHRR <br /> <br />COMPANY <br />State Cert. or Regist. I <br />. City License ~egistration . <br />***********************************.****** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />'it JMfl~ ~ /~ <br /> <br />PERMIT OFFICER. <br />