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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER'S IWm ~ IAN: Co if A J II,' t- ~t e,f y o~ Zs;ly ~t 115 PHONE <br />OWNER'S ADDRESS M La AI" L.' i) At 1 ;4 , .~ f Cl r i- <br />f . <br />JOB ADDRESS 1-,. IV ,,J ~ A i J..J A N S <5 .A- ~ U ~ f}' 'I r.J\ .' ) I (\II u w /' r .J / /j-/ A ,- r p" ,..t - u p ~ )1 J( h ,"/I s R- <br />LEGAL DESClUP'l'ION: LOT(S) BLOCK SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FRON PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:..LRew Construction ---..Addition ---..Alteration ---..Repair _Install <br /> <br />_Sign <br /> <br />--..Hove <br /> <br />--.J)eIIolish <br /> <br />PROPOSED USE: _Single Faaily <br /> <br />----.lt/F _' of Units ----.lt/H <br /> <br />_~rcial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />Restaurant fr Health Departaent Approval <br />DESClUP'l'IOR OF WOlUt: G I- 0 U tv d Lv It t c ~ R 6 {It\ {;d ,. it- t ( ~ ft.I :5 ys-tc M. <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEI1TIAL: AtTACH (2) PLOT PLARS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET ERERGY FORMS. <br />cotIKERCIAL: A'rlACB (3) SETS OF BUILDING PLANS Ii: (1) SET ERERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTION. <br /> <br />PERKITS REQUESTED <br /> <br />..1JUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />RI.RcrJUCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----.ltECIIAlIICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />~UKBDlG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPE OF CORSTRUcnOR: --..B1oclt _Fraae _Steel <br /> <br />Other <br /> <br />PDlISHBD PJ.OOR ELEVAfiORS: <br /> <br />F'I'. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />Signature <br /> <br />CONTRACTOR SECTION <br />.. ... <br /> <br />. 'mHPANY GiArt" lI~dJ~Sf) c. ; A +6 s l~ c." <br />State Cert. or Regist. . r~) (., <br />City License Registration' 7/h <br />.......................................... <br /> <br />BlJTl.DER. <br /> <br />RI.RCTRICIAR COMPANY <br />State Cert. or Regist. # <br />SilmAture City License Registration . <br />.......................................... <br /> <br />PLUKBER. COKPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />KECllARICAL COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration f <br />.......................................... <br /> <br />OTRRR COKPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICATION APPROVED BY PEBKIT OFFICER. <br />