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<br />APPLlCAnON FOR PDKIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPARTMENT <br /> <br />OWNER'S NAHE I /J.r r~ <br />r <br /> <br />RC/ -f--I-Ol" <br /> <br />PHONE /,yO~ Il.o c) <br /> <br />OWNER'S ADDRESS <br />JOB ADDRESS c,,,y ~ f' <br /> <br />JJo-t/ IlMrl <br /> <br />LEGAL DESCRIPTION: LOT(S) <br /> <br />B~SUBDIVISION <br /> <br />PARCEL I. D.' (OBTAH. FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:---..New Construction ---.Addition ---^lteration ~pair V'Install <br /> <br />--Jign <br /> <br />--Ifove <br /> <br />-1)eaolish <br /> <br />PROPOSED USE: -5iog1e Feaily <br />Veo-ercial <br /> <br />--1t/F _' of Units --1t/H <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />--Restaurant lr Health Departaent Approval <br /> <br />DESCRIPTIOR OF WORlt: 1lJ.sfd' L.. <br /> <br />c.cI'.....) <br /> <br />Atunh.S' <br /> <br />Td <br /> <br />p"..,,., ~ 0 f <br /> <br />il. rh./..;W ... <br />- <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEIITIAL : <br />COKHERCIAL : <br /> <br />ATTACH (2) PLOT PLARS i (2) SETS OF BU1LDIHG PLANS i (1) SEr EBERGY FOBHS. <br />ArlACB (3) SETS OF BUILDING PLANS lr (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTIOH. <br /> <br />PERMITS REQUESTED <br /> <br />~UlLDING <br /> <br />$ ~S(jO, 0'0 <br /> <br />Valuation of Total Construction <br /> <br />RI.RCTllICAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-1IECllAlllCAL <br />~UHBING <br /> <br />$ <br /> <br />Valuation of Hechao.ica1 Installation <br /> <br />GAS <br /> <br />ROOFIRG <br /> <br />SPECIALTY . <br /> <br />TYPE OF CORSTRUCT:lOIi: _Block _Fraae _Steel <br /> <br />Other <br /> <br />PIllISBED FLOOR ELEVAnORS: <br /> <br />Fl. <br /> <br />IS PROJECT IN FLOOD ZORE AREA' <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />COIiTRACTOR SECTION <br /> <br />.. <br /> <br />BUn.DRR <br /> <br />, COtIPANY A,..,jj Afvh/.; e <br />... <br />d ~ State Cert. or Regist. . <br />City License Registration . <br />~......................................... <br /> <br />..:I:1t:- <br />...7 7 J <br /> <br />Signature ~ RJ.1/ <br /> <br />RT.RCTRICIAIiI COMPANY <br />State Cert. or Regist. . <br />SianAture City License Registration . <br />.......................................... <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />IlECllAHIGAJ. COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration . <br />.......................................... <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. , <br />Signature City License Registration , <br />.......................................... <br /> <br />APPLICATION APPROVED BY PDKIT OFFICER. <br />