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<br />APPLICAnON FOR PERKIT <br />CITY OF ZEPBYlUIILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER'S NAHB <br /> <br />~l>V\ Hrl.V"\" 'rlvte\ Tr<A-:5-1- <br /> <br />OWNER'S ADDRESS <br /> <br />54~< <br /> <br />Gd. \I <br />fA Cl \ \ <br /> <br />'e:>\Vd) <br />Y:>\\Jd I <br /> <br />Co V""\ \,0 r'\ j PHONE <br />~e..t''''''( r hI \\s) <br />2. e f h'l r hI \ \ s ) <br /> <br />'8\'?'!-1'82- \'507 <br />t=-\ 0 y- 'Ie\. d <br />F=, \ 0 I'" \ct a <br /> <br />JOB ADDRESS <br /> <br />5435 <br /> <br />LEGAL DESCRIP'lION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.# <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:-Hew Construction -.-.Addition ~teration -.Jlepair _Install <br /> <br />_Sign <br /> <br />-Jove <br /> <br />-Deaolish <br /> <br />PROPOsmUSE: _S~leF_i~ <br />_::~.J~~erCial <br /> <br />-JIF _' of Units ----1I/H <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />Restaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: R €- \'V\ 0 '\I e. fd r -\ . I t \ OY\ W d \ \ (1 r..c\ \ e.. - \ )'\ ~ \- tl \\ c\ 00 , <br />BUlLDIRG SIZE: 1"2. Z. X ~ 0 ,\ D I q ~ 0 Square Feet, Height <br /> <br />RESIDEBTIAL: <br />COMMERCIAL : <br /> <br />An'ACII (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />An'ACII (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />/ BUlLDIRG <br /> <br />PERMITS REOUESTED <br /> <br />$ <br /> <br />~o 0 <br /> <br />Valuation of Total Construction <br /> <br />RT.RCTRICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />--.JIECBAI'1CAL <br /> <br />$. <br /> <br />Valuation of lIechanical Installation <br /> <br />-PLUllBIRG GAS ROOFING <br /> <br />SPECIALTY ' <br /> <br />TYPE OF CONSTRUcnON: ---Bl.oclt _Fraae _Steel <br /> <br />Other <br /> <br />FIlfISBED FLOOR ELEVAnONS: <br /> <br />Fl. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />" . . ." <br /> <br />BUTl.llBR ~~... . . CliIIpAIIY La,;e-(ec E,,'ll . L."".... ;L~. <br />~ State Cert. or Regist. # c: e,c.. 05 fa <=\ -, ~ <br />Signature ' Af ; City License Registration' 93 b <br />./ . ........................................ <br /> <br />RT .RCTRICIAII <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Si DnA ture <br /> <br />PLUMBER <br /> <br />COMPANY <br />State Cert. or !legist. f <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />IlECllANlGAL <br /> <br />COMPANY <br />State Cert. or !legist. f <br />City License Registration f <br />.......................................... <br /> <br />Signature <br /> <br />OTIIRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICAnOll APP1lOVllD BY '-11a.4d "'~ JJJ ~J PIlIIIlIr OFFICER. <br />