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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRIIILLS <br />BUlLDIRG DEPARTMENT <br /> <br />'-.J .a <./ /tJ. '.30 --+ /L-I <br />1T..a..~ /0 -/.1.-/ , , ( <br /> <br />OWNER'S NAHE A1;~~ R. l(1\o( m;a Y/li ']LDi \'n;rr~ <br />OWNER'S ADDRESS-::?~~5'1 7arr vr, -' Lfi!('h;1f h:JJs.' <br />JOB ADDRESS ]X hSI ~rr IJ)( ; 7.E>J?l1trhUfs <br />plA-T BI <br />LEGAL DESCRIPTION: LOT(S)T('4CT 115 P155 BLOCK <br />PARCEL LD.' 3S'-A5"-;;Q- 00)0- II 5 00 -0000 <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:__ew Construction ----^ddition ~teration ---..Repair_Install <br />_Sign --Ifove ->>eaolish <br /> <br />PROPOSED USE: .K-single Faaily <br /> <br />~/F _' of Units ---.Jt/H <br /> <br />_ec:-ercia1 <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />-..Restaurant Ie Health Departaent Approval <br />DESCRIPTION OF WORK: rntt'1\cr 1<. e t\OVqP {) 11 <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDERTIAL: <br />COMKERCIAL : <br /> <br />ATTACH (2) PLOT PLANS Ie (2) SETS OF BUlLDIRG PLANS Ie (1) SET ENERGY FORMS. <br />ATTACH (3) SErS OF BUlLDIRG PLANS Ie (1) SET ENERGY FORHS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REQUESTED <br /> <br />~U1LDIRG <br /> <br />$ <br /> <br />Va1uation of Total Construction <br /> <br />RT.RCrIU.CAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />---llECBAlllCAL <br /> <br />$ <br /> <br />Va1uation of Kecbanica1 Installation <br /> <br />----PLUKBIRG GAS ROOFING <br />TYPE OF COIISTRUcnON: ~loclt _Fraae _Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FDlISBED nooR ELEVAfiONS: <br /> <br />FT. <br /> <br />IS PROJEC'l IN FLOOD ZONE AREA! X <br />YES NO <br /> <br />.......................................... <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br /> <br />mtlPANY () 077.//l/ <br />/ "',f 7J () In~..:-If-;-- State Cert. or Regist. . <br />~ ~~' City License Registration . <br />**************************************.*** <br /> <br />COMPANY (f) 1~>-17 -I/}"/ <br />State Cert. or Regist. . <br />City License Registration . <br />************************************...**. <br /> <br />RtJTIJ)RR <br /> <br />RI.RGTRICIAII <br />SignAture /lJ1L~/ /1~ <br /> <br />PLUKBER<< - COMPANY Lof#tP /2 /?/V,,{# i:,/~ 'ir <br />,;J // ~ State Cert. or Regist. . v <br />Signature !~ City License Registration . /2 7 <br />- ..~........................~.......... , <br /> <br />KECHANICAL COMPANY lLL (.d-J11~ <br />1/1/1/ fj 17 f) .~ State Cert. or Regist. . <br />Signature I/rw~ !l!~ City License Registration' <br />*.........**..******.********************* <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />*.**..***..***.*....*..**.**...*....*.***. <br /> <br />APPLICATION APPROVED BY PERKIT OFFICER. <br /> <br />.~ <br />