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<br />APPLICATION FOR PElKI.T <br />CITY OF ZEPIIIlUIILLS <br />BUILDING DEPAR'l'HENT <br /> <br />. . <br /> <br />~~ <br /> <br />OWNER'S NAKB ~Al r///llJje ./it?/t/Jefs <br /> <br />OWNER'S ADDBBSS /965/ IRAL~ ~~ .tlou~ <br />C, /5d ~~ ~~ 9~ <br />fll~e \ <br />LEGAL DESCRIPTION: LDT(S) I B~SUBDIVISION $t2..J-A. ~ <br />PARCEL LD.' O"S-;)6-a/ -O/:;;/J -~ -CP)O (OBTAIN FROM PROPERTY T~ NOTICE) <br /> <br />WORK PRoPOsED:hew Construction ----..Addition -----Alteration -....Repair _Install <br /> <br />PHONE (};.;) 19/- 73tt <br /> <br />JOB ADDRESS <br /> <br />_Sign <br /> <br />---.-.Hove <br /> <br />---->>eaolish <br /> <br />PROPOSED USE: .xsiogle Faaily <br /> <br />---1:I/F _' of Units' ---1:I/B <br /> <br />_~ercial <br /> <br />_Iodust. _Swia. Pool _Other <br /> <br />-....Restaurant &: Health Departaent Approval <br /> <br />DESCRIPTIO. OF 1lOIllC: 4 4- ~ <br />/ <br />BUILDING SIZE: X Square Feet, <br /> <br />Height 3u. ~I ~/ <br /> <br />RESIDEHTIAL: ATTACH (2) PLOT PLANS &: (2) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. <br />COHKERCIAL ATTACH (3) SETS OF BUILDING PLANS &: (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />X-aUILDING <br />Y RT.RcrRIcAL <br />L.,mCIWUCAL <br />X ,,-. <br />~UKBDlG <br /> <br />$ <br /> <br />6S:00d <br />IS6 <br />--- <br />=ail!: AHP Service <br /> <br />Valuation of Total Construction <br />)( Florida Power Corp. <br /> <br />.,., . <br /> <br />W.R.E.C. <br /> <br />$ ~9~o <br /> <br />Valuation of Hechanical Installation <br /> <br />GAS <br /> <br />)( ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF COBSDUcnON: ...KJsloclt _Fraae _Steel <br /> <br />Other <br /> <br />FIlIISBBD FLOOR ELEVAnOJlS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? -X- ~ // <br />YES NO Zt:J;Je c <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION' <br /> <br />COHPAliY <br />, State Cer . or BeRt .. <br />{;{ - City License Registration . <br />'. ..........***..*****..........*.***... <br /> <br />RT.RCTRICIAN . COMPANY 5,1.5 Elee-r ~ kc <br />;;J2. , State Cert. or Regist. . E~~t?o ;2.,Ol../t- <br />SilmAture ~..-/ ~ ~~ City License Registration', .2 1/ r <br />.....*...*.....*...............*.....*.... <br /> <br />BUTlJ)ER <br />Signature ~ <br /> <br /> <br /> <br />PLlIlBER ~ COO'ABY ;./&</I/W7OJV ,t-~ rPLv~/"-9' <br />c..' St4te Cert. or Resist. . cR F 0 ~ ~ / " <br />Sigoatur ~~ty LiceDSe Registration . ~l# j t. 'I <br />................ ...........~..........~ . ~ <br />COMPANY -/I,e e -A c C"'-o,.LP c, , <br />State Cert. or Regist. . C-A CO :3 2-LLC/7 <br />City License Registration' I C;;-I . <br />.......................................... <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />I!l...............*.*..........~~~~.~.... <br /> <br />APPLI10.~. \ ',' .t.'.~..~~.~.~. .. <br />...-..0" [ .. ...,'1 ~ <br />-~)O'AIIllIO . . .... ,",:..,.. <br /> <br /> <br />FICER. <br />