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<br />1 <br /> <br />APPLICATION FOR PERK1T <br />CITY OF ZEPIIYRIIILLS <br />BUILDIBG DEPARTKENT <br /> <br />OWNER'S <br /> <br />NAKE ~4~Le5 k721e... <br />ADDRESS ~0.39 ~a~. 57. <br />~~ <br /> <br />PHONE ?F2-2Z7' <br />- CJ;4KSltJe' /)tt). ;jL(). ~ <br /> <br />OWNER' S <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPT'ION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />WORK PROPOSED:~New Const.ruct.ion _Addition _Alt.eration _Repair _Inst.all <br /> <br />_Sign <br /> <br />_Hove <br /> <br />_D~lish <br /> <br />PROPOSED UJSE: <br /> <br />Single F:mily <br /> <br />_H/F <br /> <br />_, of Unit.s <br /> <br />*H/8 <br /> <br />_~ercial <br /> <br />_Indust. . <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />_Restaurant. 5: Health Departaent. Approval <br /> <br />BUILDING SIZE: <br /> <br />1-'1- X 3b' . <br /> <br />Sb c.f <br /> <br />Square Feet., <br /> <br />I S--~IJl~ <br /> <br />Height. <br /> <br />RESIDENTIAL : <br />cotIPIERCIAL : <br /> <br />ATI'ACH (2) PLOT PL.MiIS &: (2) SETS OF BIJIILDING PLANS &: (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUI.LDING PLANS &: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY RIl'.QtllIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~ <br /> <br />PERKITS REOUESTED <br /> <br />.$BUlLDING <br />..:t-ELECTRIGAL <br />~MEClWilCAL <br />4-PLUHBING <br /> <br />$ <br /> <br />.;111 f jV~ <br /> <br />. <br /> <br />Valuat.ion of Total Const.ruction <br /> <br />I ~O AIIP Service <br /> <br />* Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />I ?>oo " <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCl'ION: _Block. _Fr:me _St.eel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: .~ FI' . <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />tttttttttttttttttttttttttttttttttttttttttt <br /> <br />CONTRACTOR SECI'l.ON <br /> <br />BUlIJ)ER ~~ <ntPMIY 1./.. it ~ <br />Stat.e Cert. or Regist. , <br />Signat.ure Cit.y License Regist.ration , .3 Sb <br />~ .......................................... <br /> <br />COHPANY rY i Ii. .,ToILO ~ s t..f:::C-TlLt--z- <br />Stat.e Cert. or Regist.. , <br />Cit.y License Regist.ration' .#-3 ;119" <br />...........................~.. <br /> <br />PLUKBER ~ COKPMiY Ni,h...J ~ <br />"111J' Stat.e Cert.. or Regist. , <br />Signat.ure (f~ Cit.y License Registration' /i) p-- <br />tttttttttttttttttttttttttttttttttttttttttt <br /> <br /> <br />ImmAllICAL ~ ~ <ntPAIIY €:!"'"^~ iL tJ4>-'i. C-e-r · ~ . <br /> <br />. . \ ~ / State Cert. or Regist. , <br />Signature ~ 8~ ~ Cit.y License Registration' 7 ~ <br />tttttttttttttttttttttttttttttttttttttttttt <br /> <br />OTHF.R <br /> <br />GOKPARY <br />Stat.e Cert.. or Regist.. , <br />Cit.y License Regist.ration , <br />tttttttttttttttttttttttttttttttttttttttttt <br /> <br />Signat.ure <br /> <br />APPLICATION APPBOVED BY <br /> <br />.~,:t"',lOl...,,". '.';'\"l<.','.';:,: <br /> <br />lftGi... <br /> <br />PERlfIT 0F$~~1 <br />~'1 <br /> <br />I' """~"'''''''~'1' <br /> <br />,;, ......,.. <br />~ <br /> <br />f <br /> <br />C~?<i),,""'l...Ml'f_'........... <br />