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<br />APPLICATION FOR PERKI.T <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTKENT <br /> <br />OWNER 'S NAKE <br /> <br />'(3..fJ.-1t y RON) (~Pn e;<,./ <br />/ <br /> <br />PHONE 78;2 -8 77 Y <br /> <br />OWNER 's ADDItESS <br />JOB ADDRESS 3 B 7 (]V <br /> <br />g~A-u~ <br /> <br />LEGAL DESCRIPTI.ON: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN nOR PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ----"ddition -----Alteration --Repair_Install <br /> <br />_Sign <br /> <br />~ve <br /> <br />~eIIOlish <br /> <br />PROPOSED USE: ~ing1e Feaily <br /> <br />---1J/F _' of Units ---1J/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />---Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: d '7 ON I? ~ tI (p. C h a"':} 12 tP- cvI- <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: ArrACK (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />COHKERCIAL: ArrACK (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKI.TS REQUESTED <br /> <br />.-BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RT.RcnuCAL <br /> <br />AIIP Service Florida Power Corp. <br />$#~,;2.6 5: aD Valuation of Kecbanica1 Installation <br /> <br />W.R.E.C. <br /> <br />----1IEClWllCAL <br /> <br />-PLUMBING GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF OOBSTRUCTION: ~loclt _Fraae _Steel <br /> <br />Other <br /> <br />FIIIISHED FLOOR. BLEVAnOBS: <br /> <br />n. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRActOR SEctION <br /> <br />BIITIJ)ER <br /> <br />I11W-/ <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />(V/o (yr;; ,u <br /> <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />RT .RCTRICIAIJ <br /> <br /> <br />COKPANY <br /> <br />G 1~8'(A:~ <br /><1/ <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br /> <br />COIIPA1IY Ii> ^' sit~ r:.ONifr~ <br />State Cert. or Re st.' boS}//.2.. <br />City License Registration' 7/ <br />.......................................... ' <br /> <br />HECBANICAL <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 />PBRHIT OFFICER. <br />