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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYlUIILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S ADDRESS <br /> <br />U-J;J12L j [- <br />J qoo ~ <br />'3(00) <br /> <br />v/J;L <br />LV iiJ,f iI/;'.l- U/ <br />LV I' Otf v/t w <br /> <br />PHONE <br /> <br />?to -/rJ 7 <br /> <br />OWNER'S NAHB <br /> <br />L..11.I <br /> <br />JOB ADDRESS <br /> <br />I-/V <br /> <br />LEGAL DESCRIPTION: LOT(S) BLOCK SUBDIVISION <br />.........-......-......'..., 0 () <br /> <br />C:P~CEL Ton . ), 11(- ~1e--:;2/(-)I)OD -OOt2.00-00 (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:---1iew Construction ----Addition --Alteration -.Jtepair ._Y-:;::~li <br /> <br />_Sign <br /> <br />--Kove <br /> <br />~eaolish <br /> <br />~ <br />PROPOSED USE: ~ing1e F_ily <br /> <br />---1t/F _' of Units ---1t/H <br /> <br />_ec:-ercia1 <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />-.Jtestaurant Ii Health Departaent Approval <br />DESCRIPTION OF WORK: //U.5 ~4// /l,/c~ ;;c.A/~~4L AF4//;o.:.? ~ C""""L..-AY ~ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ATtACH (2) PLOT PLANS Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />cotIKERCIAL: ArrACH (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />Va1uation of Total Construction <br /> <br />RT.Rc;nuCAL <br />~awu.CAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />;z ?f5 <br /> <br />Va1uation of Mechanical Installation <br /> <br />_PLUKBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSTRUcnON: -..Block _Fralle _Steel <br /> <br />Other <br /> <br />FIRISBED FLOOR ELEVAnORS: <br /> <br />n. <br /> <br />IS PROJEct IN FLOOD ZONE AREAT <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />RIITIJ)RR <br /> <br />COKPARY <br />State Cert. or Resist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />RT.RCTRICIAR <br />SianAt.ure~' <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />PLUKBER <br /> <br />Signature <br /> <br /> <br />COKPANY <br />State Cert. or Resist. . <br />City License Registration . <br />.............................~............ <br /> <br />Signature <br /> <br />tlECIIAliICAL <br /> <br />COMPANY S(/JJ~/()~ ~'E4#A;6 d C a:J~/~~ <br />State Cert. or Regist..' C /!-c:: <::; 5/5// <br />City License Registration f <br />.......................................... <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERKIT OFFICER. <br />