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<br />APPLICAnON FOR PERMIT <br />CITY OF ZEPllYRllILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAME ~'c.h.(J~J') /l1c!'~/'L L <br /> <br />OWNER'S ADDRESS ~ J 2 9 <br />JOB ADDRESS ~,,/?? t <br /> <br />LAP,e .s; r <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />BI.OClL--SUBDIVISION <br /> <br />PARCEL I.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction -Addition -Alteration --.Jlepair _Install <br /> <br />_Sign <br /> <br />---.J(ove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single F_ily <br /> <br />----l!tIF _' of Units ----l!tIH <br /> <br />_ec:-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />--.Jlestaurant Ii Health Departllent Approval <br />DESCRIPTION OF WORK: IIV'; r 111 / / lIc: W, /t./~';( T <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COKKERCIAL : <br /> <br />An'ACH (2) PLOT PLANS Ii (2) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />An'ACB (3) SETS OF BUILDING PLANS Ii (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Is-eo. 00 <br /> <br />Valuation of Total Construction <br /> <br />_ELEcrRICAL <br /> <br />AtIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CllABICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />_PLUMBING GAS ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPE OF CONSTRUCl'ION: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVAnONS: <br /> <br />FT. <br /> <br />IS PROJEC'l IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />COHTRACTOR SECTION <br /> <br />RmlllER <br /> <br />cOtIPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />RT.RCTRICIAR / ~ COMPANY;{f c;; If I <.tJ C/~'#trJ<.,j"fi L ~/E"( 7~ t'" L ('O-t.;'~ <br />:::: L';. j) /" ,. 0- State Cert. or Regist.'_ A <br />8i- '_ ei~"'-<_ Cc.~xtZ{f' City License Registration . <<-Va <br />. .......................................... <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration , <br />.......................................... <br /> <br />Signature <br /> <br />IlECllARICAL COMPANY tS'4H~!s ~"'A^,~ b'''''s e. IJIt r/fJC, <br />~/ ./ ~ State Cert. or Regist. , C.AC.o~7Cf ';'8 <br />Signature . p. City License Registration f 78 <br />.......................................... <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLICATION APPROVED BY PERMIT OFFICER. <br />