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<br />// ~.. d""' fl- <br />OWNER'S NAME ,~ . I ~ <br />OWNER'S ADDRESS ,. 0 y / I 7.4 <br />J-{) L.; / I 7 J!t <br />LEGAL DESCRIPTION: LOT(S) pel p(J. 51- <br /> <br />APPLICATION FOR PERKlT <br />CITY OF ZEPRYRBILLS <br />BUILDING DEPARTMENT <br /> <br />\.~4-ra~ <br /> <br />/ J-- -_5-'7Y <br /> <br />PHONE <br /> <br />7 I ;'- o'} tJ ~ <br /> <br />JOB ADDRESS <br /> <br />BLOCKall:J SUBDIVISION ,_. <br /> <br />--..-'. <br /> <br />PARCEL 1. D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED: V~ew Construction ~ddition ~teration _Repair _Install <br /> <br />_Sign <br /> <br />--",ove <br /> <br />_Deaolish <br /> <br />PROPOSED USE: _Single Fallily <br /> <br />--"'IF <br /> <br />_, of Units <br /> <br />_K/B <br />VOtherJ-4 <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />_Restaurant & Health Departaent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: / ..( X /" . / If 1- <br /> <br />Square Feet. fj'/ 0/'" Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORKS. <br />ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />_BUILDING <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTRICAL <br /> <br />AMP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />~CllANlCAL <br /> <br />$ <br /> <br />Valuation of Kechanical Installation <br /> <br />~UH8IRG GAS ROOFING <br />TYPE OF CORSTRUC'l'IOR: _Block _Fralle V Steel <br /> <br />SPECIALTY <br /> <br />Other <br /> <br />FlRISUED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />****************************************** <br /> <br />CONTRACTOR SECTION <br /> <br />BUILDER <br /> <br />Signature <br /> <br />COKPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />F.I.RCTRICIAN <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****************************************** <br /> <br />SiQJlAture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />**********************************.......* <br /> <br />Signature <br /> <br />MECHANICAL <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />****..**.*..**.....*...***..****.*.*...... <br /> <br />Signature <br /> <br />OTRF.R <br /> <br />COMPANY <br />State Cert. or Regist. , <br />City License Registration , <br />*.**.****..*...........**...*..*...*..*..* <br /> <br />Signature <br /> <br />APPLICATION APPIlOVEO BY l! ~ fJ1 c-o-~ <br /> <br />PERMIT OFFICER. <br />