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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPBYIUIILLS <br />BUILDING DEPARTHENT <br /> <br />OWNER I S NAHE <br /> <br />1?,L! ( Su II;v~;v <br />39/S-"5 '5'il~JL <br />5'~.P <br /> <br />PHONE 7 f3;;( - .3 S;-f5"5 <br /> <br />OWNER I S ADDRESS <br /> <br />JOB ADDRESS <br /> <br />LEGAL DESClUPTI.ON: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL !.D.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:-Jew Construction ~ddition -Alteration -....Repair ,_Install <br /> <br />_Sign <br /> <br />---.JIove <br /> <br />--->>eaolish <br /> <br />nOPOSW~E: ~~eF_ily <br /> <br />--J4/F _' of Units --J4/H <br /> <br />_ec-ercial. <br /> <br />_lDdust. _Swia. Pool _Other <br /> <br />DESCRIPTION OF WORK: <br /> <br />-....Restaurant Ii: Health Departaent Approval <br /> <br />C h ~ro <br /> <br />d:l.. VtJ-A) <br /> <br />//~p <br /> <br />c;J~ <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEIITIAL: ATTACH (2) PLOT PLANS Ii: (2) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. <br />COMMERCIAL: ATTACH (3) SETS OF BUILDING PLANS Ii: (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />~UlLDING <br /> <br />$ <br /> <br />Val.uation of Total Construction <br /> <br />RI-ECTRICAL <br /> <br />AID' Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----"ECIIAlIICAL <br />-PLUMBIBG <br /> <br />$ <br /> <br />~ "? 6-0_ bV <br /> <br />Val.uation of Kechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF COISTIlUCTION: ---Block _Fr.-e _Steel <br /> <br />Other <br /> <br />FI.RISBED FLOOR ELEVAnONS: <br /> <br />Fl. <br /> <br />IS PROJEct IN FLOOD ZONE AREAl <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />BIJTI.DRR <br /> <br />RI.RCTRICIAII <br /> <br /> <br />COIIPAMY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Mo;e(O t&1 <br /> <br />Signature <br /> <br />If, <br />~ <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />6 1(fJ, -(t/~ <br />j:J f/ <br /> <br />PLUMBER <br /> <br />IlECIIAliIGAL <br /> <br />Siguature L~' <br /> <br />omRR <br /> <br />JC/L-- <br />( <br /> <br />COMPANY <br />State Cert. or Regist. f <br />City License Registration . <br />.......................................... <br /> <br />COMPANY X;' IV S..4-7 C _a~"o;: ~ <br />State Cert. or Re~t. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />o CJS--r/.J <br />- <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLICATION APPROVED BY <br /> <br />Y!dh1"~ !J1 "* LJ <br /> <br />PERKIT OFFICER. <br />