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<br />APPLICATION FOR PERMIT <br />CITY OF ZEPBYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAHE <br /> <br />L1~;;PJLn-4:_0N <br />~ 5 ~ I a ,,. t/ <br />/ <br />5~~ <br /> <br />PHONE 788 -6 Bs--V <br />b 17 Av.R ,de?/' L <br /> <br />OWNER'S ADDItBSS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESCRI.PrlON: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:-Rew Construction ----..Addition ---...Alteration --.Jlepair ,_Install <br /> <br />_Sign <br /> <br />--.JIove <br /> <br />----Peaolish <br /> <br />pmPOsmmE: ~~eF_ily <br /> <br />---1i/F _' of Units ---1i/H <br /> <br />_ec-ercia1 <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />---.-.Restaurant Ii: Health Departllent Approval <br /> <br />DESCRIPTION OF WORK: <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />. <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COtlHERCIAL : <br /> <br />A'l'TACB (2) PLOT PLANS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. <br />A'l'TACII (3) SETS OP BUILDING PLANS Ii: (1) SET ENERGY PORKS. <br />PROPERTY SURVEY REQUIRED POR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTm <br /> <br />~UlLDING <br /> <br />$ <br /> <br />Va1uation of Total Construction <br /> <br />RT.ECl'Rl.CAL <br /> <br />AIIP Service Florida Power Corp. <br />./ ........cri) <br />$ ..z I /'.5 # Va1uation of tlecbanica1 Inst:al.lation <br /> <br />W.R.E.C. <br /> <br />-1IEClWlICAL <br />--...PLUtlBIXG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OP COIlSTRUcnON: ---..Block _Pr_e _Steel <br /> <br />Other <br /> <br />FIIIISBED FLOOR ELEVAUOIlS: <br /> <br />Fl. <br /> <br />IS PROJECT IX FLOOD ZONE AREA! <br /> <br />.................................*..*.**** <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />Birr' .Dm <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration . <br />****************************************** <br /> <br />Signature <br /> <br /> <br />COKPANY <br />State Cer . or Regist. . C!> CJ <br />City License Registration . <br />*********************.*****.********* <br /> <br /> <br />PLUtlBRR <br /> <br />COKPANY <br />State Cert. or Regist. . <br />City License Registration t <br />************************.*.*..**.********* <br /> <br />Signature <br /> <br /><."'- <br /> <br /> <br /> <br />COKPANY C"rV ~ <br />State Cert. or Re st. t 4J () <br />City License Registration . f!!P <br />****************************************** <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration t <br />***.************************.**.********** <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />PERMIT OPPICER. <br />