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<br />/J- -c..-~;-Y. <br /> <br />APPLICATION FOR PERKlT <br />CITY OF ZEPBYRBILLS <br />BUILDIRG DEPAR'1'HENT <br /> <br /> <br />OIlIlllR'S _ 4..# ~#/{ r;71VPrfid7J~A.II<f{;.. 2 PIIO.11 Z,f2-,-to// <br />OWRER'S ADDRESS <;f()JJ //7/) ~E ?F.P~J/?H/../LJ <br />JOB ADDRESS 3i())J //TIJ 46-, <br /> <br />LEGAL DESClUP.flON: LOT(S) <br /> <br />BLOCK ~ SUBDIVISION <br /> <br />PARCEL I.D.t <br /> <br />(OBTAIN FROH PROPERTY TAX. NOTICE) <br /> <br />WORK PROPOSBD:~ew Construction -..Addition --1a1teration -.Jlepair z.--;rnAtall <br /> <br />_Sign <br /> <br />---lIove <br /> <br />-1)eaolish <br /> <br />PROPOSED USE: ~ing1e Faai1y <br />Vec-ercial <br /> <br />---1t/F _' of Units ---1t/H <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />-0estaurant &: Health Departaent Approval <br />DESCRIPTION OF NORIt: t::A/f7';(J-U- ()l~,o /:3IJ/J/L}}//" ~jjj:)J//'~ ~~ )~J??zrJf/oAl -rV.fTrm <br />BUILDIRG SIZE: X Square Feet, Height <br /> <br />RESIDEIITIAL: <br />COHKERCIAL : <br /> <br />ATTACK (2) PLOT PLANS &: (2) SETS OF BUlLDIRG PLANS &: (1) SET ENERGY FORMS. <br />ArrACK (3) SETS OF BUlLDIRG PLANS. (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERKITS REQUESTED <br /> <br />----.JIUILDIRG <br /> <br />$. <br /> <br />Valuation of Total Construction <br /> <br />Rl.R.CDU.CAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E,C. <br /> <br />~CIWIlCAL <br /> <br />$. L/'('~ I cnJ <br /> <br />Valuation of llecbanical Installation <br /> <br />----l'LutlBDlG GAS ROOFDIG <br />TYPE OF CONSmUCrION: ~1oclt _Fraae _Steel <br /> <br />SPECIALTY . <br /> <br />Other <br /> <br />Fl. <br /> <br />IS PROJEct 1.N FLOOD ZONE AREA' <br /> <br />~ <br /> <br />FIllISBBD FLOOR ELBVAnONS: <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />CONTRACTOR SECTION <br />. . <br /> <br />. 'OOHPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />BUILDER <br /> <br />Signature <br /> <br />Rl.RCTRICIAIII <br /> <br />SillmAture <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />PLutlBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />tlECllANICAL COMPANY ?~R xi M ~p <br /> <br />State Cert. or Regist. . . <br />Signature City License Registration f <br />...............*.......................... <br /> <br />IITIIRR CIllIPAIIY <;'E' ("//17' :?( ~~,;:>~ <br />. d d State Cert. or Reg st. . /J ,/01S <br />Signature ,?/; ~(("tb.vYt- City License Registration . <br />~ .......................................... <br /> <br />(, <br /> <br />APPLICATION APPROVED BY PERHIT OFFICEll. <br />