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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTKENT <br /> <br />OWNER'S NAtIE 8,D\ 1\ \ C- <br />OWHER'S ADDRESS 0 Uslt () <br />- lL <br /> <br /> <br />~~d - oLILk5 <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: lOT(S) l~ BlOCK <br />PARCEL LD..c::Q -d/D - :=J 1 -CX)IO -05/(X) <br /> <br />SUBDIVISION <br />- cx:x:J:) (OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />!CU) <br /> <br />WORK PROPOSED:~ew Construction ---..Addition --..Alteration --.Jlepair~Iostall <br /> <br />_Sign <br /> <br />---'love <br /> <br />->>eaolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />---Jl/F _' of Units ~/B <br /> <br />_ec-ercial <br /> <br />_Iodust. _Swia. Pool _Other <br /> <br />.-Restaurant II: Health Departaent Approval <br />DESCRIPTION OF WORK: '(\R.\r~l 3~ ~Jc --' r/l r C{)l) c9, l J\l ; + <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 />COMHERCIAL: ATTACH (3) SETS OF BUILDING PLANS II: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REQUESTED <br /> <br />-BUILDIBG <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />-...! RT.RCrIUCAL <br /> <br />AHP Service Florida Power Corp. <br />1':::;:-0C;" o~ <br />$ ^--J 7 L Valuation of Kecbanical Installation <br /> <br />W.R.E.C. <br /> <br />..2!:-JIECllAllICAL <br /> <br />---..PLUflBIBG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUCTION: ____lock _Fr8lle _Steel <br /> <br />/J111 <br /> <br />Other <br /> <br />FDlISBED F100ll ELEVAnONS: <br /> <br />n. <br /> <br />IS PROJECl IN FLOOD ZONE AREAT <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRActOR SECTION <br /> <br />BIITI.DER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................*.* <br /> <br />Signature <br /> <br />. <br />RI.RCTRICIAN COMPANY / <br />a - 'r::J(eJ1. );, State Cert. or Regi... .e.=o <br />SilmAture C//I r 0Dn City License Registration' <br />......................*...**.........*..** <br /> <br /> <br />PLIDIBER <br /> <br />COKPANY <br />State Cert. or Regist. , <br />City License Registration . <br />.....................*.............*.**..* <br /> <br />Signature <br /> <br />HECllANlCAL COMPANY /lIP.... 'Rtc{; /9(0 ~ ~<<-' <br />'-tltt.' h ~/ ~ ) State Cert. or Regiat:; __:5 - <br />Signature C 'IS:{P . YJr :!Jon.. City License Registration f 'ILl? <br />..*.............*.*.*...............**... <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration . <br />.......................................*.. <br /> <br />APPLlCAnOlt APPROVED BY PERHIT OFFICER. <br />