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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYRDILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER · S N.AIIB <br /> <br />PHONE <br /> <br />OWNER' S ADDBBSS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRIPTION: I.OT(S) <br /> <br />BLOClL--SUBDIVlSION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:-Hew Construction --Jddition --Alteration ---..Repair _Install <br /> <br />_Sign <br /> <br />---.JIove <br /> <br />-Peaolish <br /> <br />PROPOSED USE: -Bingle F_ily <br /> <br />---Jt/F _' of Units ---Jt/B <br /> <br />_~ercial <br /> <br />_Indust. -Bwia. Pool _Other <br /> <br />Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEIITIAL: <br />cotIMERCIAL : <br /> <br />AnACB (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />ArlACB (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />PROPERTY SURVEY REQUI.RED FOR ALL NEW CONSTRUCTION. <br /> <br />-BUILDING <br /> <br />$ <br /> <br />. PEmuTS .REOUESTED <br />. i1 () <br />h 50 .- Valuation of T~tal Construction <br /> <br />RT.~crJUCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--.JIEClWlICAL <br />-...PLUHBING <br /> <br />$ <br /> <br />Valuation of lIechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPE OF COISDUcnON: ---..B1ocIt -Prue _Steel <br /> <br />Other <br /> <br />FlllISBBD PI.OOIl ELEVAnOIS: <br /> <br />Fl. <br /> <br />IS PROJECT IN FLOOD ZOIE AREA! <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />. . .' CONTRACTOR SECTION <br />. .., .~ ~ . ) <br />pml.DRR, .,~. .' . 'eldHPAIIY -" rYm-i. r;w.J7J~/1/. <br />. {State Cert. or Regist. . <br />Signature. ~r<[ - ...L-<-- City License Registration . <br />~ ........ ................................. <br /> <br />RT.RCTRIC1M4 COMPANY <br />State Cert. or Regist. . <br />SiDnAture City License Registration . <br />.......................................... <br /> <br />PLUMBER. COKPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />IlECBART~ COKPANY <br />State Cert. or Regist. . <br />S1goature City License Registration f <br />.......................................... <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br />