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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPHYRHILI..S <br />BUILDING DEPARntmn' <br /> <br />OWNER · S BAKE <br /> <br />Sf' m Ij'1Dr-~ .-.11 <br />3 q I J ~- 0 I rJ <br />S 029 <br /> <br />OWNER · S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />m-e.mOf<7 <br /> <br />~ <br /> <br />LEGAL DESCRIPTION: LOT(S) <br />PARCEL LD.' J 2-/U) 2.1 <br />I ' <br /> <br />J-t G) me ) <br /> <br />m,;1 Lq~-p <br /> <br />LetVle <br /> <br />PHONE <br /> <br />782 - 275 '3 <br /> <br />BLOCK <br /> <br />SUBDIVISION )' U IY1 hi P.r ) I J / <br /> <br />WORK PROPOSED:_Nev Construction _Addition _Alteration _Repair _Inst.a1l <br /> <br />_Sign <br /> <br />PROPOSED USE: <br /> <br />Single Faldly <br /> <br />_Co_ercial <br /> <br />_Hove <br /> <br />_De.-olish <br /> <br />_H/F <br /> <br />_' of Units <br />~svi.. Pool <br /> <br />_H/B <br />SCN p, E r!CJ....., NO ther <br /> <br />BUILDING SIZE: <br /> <br />_Restaurant 5; Health Depart:aent Approval <br /> <br />_Indust. <br /> <br />x <br /> <br />Square Feet. <br /> <br />He ight <br /> <br />RESIDENTIAL: <br />COMKERCIAL : <br /> <br />ATTACH (2) PLOT PLAliIS 5; (2) SETS OF BUILDING PLANS 5; (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDING PLANS 5; (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL liEW CONSTRUcnON. <br /> <br />_BUILDING <br /> <br />$ <br /> <br />_ELECTRICAL <br /> <br />AKP .service <br /> <br />_HECHMlICAL <br /> <br />$ <br /> <br />_PLUKBING <br /> <br />GAS <br /> <br />PERKITS REOUESTED <br /> <br />Valuation of Tot.a1 Construction <br /> <br />Florida Pover Corp. <br /> <br />W.R.E.C. <br /> <br />Valuation of Mechanical Installation <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />TYPE OF CONSTRUCTION": _Block _Fraae _Steel <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />~~~~*~*~tt~~~*~~t~~~~~~~~***~~*~~~~~*~**~* <br /> <br />YES NO <br /> <br /> <br />CONTRACI'OR SECTION <br />cotJPANY () / ~ hi 0/1 J ~ f <br />State Cert. or Regist. t PC <br />City License Registration . <br />*~~~**~~~*****~*~*~*~~*~~~*~~*~~*~~~~~*~~* <br /> <br />~d~ <br />o 7 b <br />if "J 2. <br /> <br />po" j <br />BUILDER <br /> <br />COHPANY C 0 ~ j + I,l'l-(' <br />~ \ ~ ~. Sta<e Cer<- or Regis<- , <br />~ rCL"I '-t.. City License Registration <br />*~~**** **~~~******~*~*~*************~**** <br /> <br />ELECTRICIAN <br /> <br />Signature <br /> <br />f' Le c.t <br />~R(,)o/3oYO <br />t '27~ <br /> <br />PLUMBER <br /> <br /> <br />COHPARYY (eLm 0"\ J e.Qp;'~ 61~ J... J.., <:. <br />State Cert. or Regist. , C PC o3:? 7 If " <br />City License Registration t -# '3 2- <br />~**~************~*~***************~**~**** <br /> <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />Signature <br /> <br />CottPAHY <br />State Cert. or Regist. I <br />City License Registration t <br />*******~*****************~**~***~**~****~* <br /> <br /> <br />COHPANY 0 ( A. IYI ".J R "D f PO.1 I r," <br />State Cert. or Regist. I . ~c. J <br />City License Registration t A' J J <br />**~*******~***~~***~********~~************ <br /> <br />I..., Co. <br />, (017H7 <br />:t::1'l.J O~ <br /> <br />APPLICATION APPROVED BY <br /> <br />PERHIT OFFICER. <br />