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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTKERT <br /> <br />OWNER'S NAME <br /> <br />/!7/,LJ/Vl / J:;~S <br />5<';yO 04// <br />M/11G <br /> <br />PHONE <br /> <br />783-3/0( <br /> <br />OWNER'S ADDRESS <br /> <br />15 Iv/J <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESClUP'I'ION: LOT(S) <br />PARCEL LD.' <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ---..Addition ---lUteration ---..Repair -_Install <br /> <br />_Sign <br /> <br />--..JIove <br /> <br />~eaolish <br /> <br />PROPOSED USE: ~iog1e F_ily ---1t/F _' of Units <br />~ec:-erCial _Indust. _Swia. Pool <br />--Restaurant & Health Departaent Approval <br /> <br />---1t/H <br /> <br />_Other <br /> <br />DESCRIPTION OF WORK: ///L <.- <br /> <br />~f) I) t t' .r.f'/O N <br />I I <br /> <br />/N <br /> <br />h* /-/t'N <br /> <br />d~tJ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />. <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: AtTACH (2) PLOT PLARS & (2) SETS OF BUILDING PLABS & (1) SET ENERGY FORMS. <br />COMMERCIAL: AtTACII (3) SETS OF BUILDING PLABS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~UILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RT.RCTlUCAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--lIEClWlICAL <br /> <br />$ -$I in;,. cJ-O <br /> <br />Valuation of lIecbanica1 Installation <br /> <br />-PLtllBDfG GAS ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF COISTRUcnOB: ----Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FUJOR ELEVAUOBS: <br /> <br />Fl'. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br /> <br />RIJTIJ1RR <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />RT.RCTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />SignAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Reaist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />IlECIIAlfiCAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />I <br /> <br />Signature <br /> <br />Signature <br /> <br /> <br /> <br />COKPANY (:.M/YJ C "to,lf t h/U..- EQv / f) . <br />State Cert. or Reaist. . 3tJ yt. 3 -; OOOJ. t58 <br />City License Registration' (p 38 <br />.................................... <br /> <br />OTRRR <br /> <br />APPLICAUON APPlWVED B <br /> <br />PERMIT OFFICER. <br />