Laserfiche WebLink
<br />APPLICAnON FOR PERKIT <br />CITY OF ZEPlIYRBILLS <br />BUILDING DEPARTKERT <br /> <br />OWNER'S IWtK 1& 2,-: / D aJ/-e 51 PHONE <br />OWRER'S ADDRESS {; r :3 G ~c;if'/ <7 r <br />JOB ADDRESS ~// (yY)~. '/ (c:; .p- f..- <br />LEGAL DESCRIPTION: LOT(S) BLOCIt.....--SUBDIVISION <br /> <br />'?32~3;>?2. <br /> <br />Oa4/:RL B/~ <br /> <br />PARCEL LD.' <br /> <br />(OBTAIN FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED:~ew Construction ---"ddition ~teration XRepair _Install <br /> <br />_Sign <br /> <br />--1k>ve <br /> <br />_Deaolish <br /> <br />PROPOSED~E: _S~eF~i~ <br /> <br />~/F _' of Units ~/H <br /> <br />_~ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />DESCRIPTIOII OF WORK: <br /> <br />--.-:Restaurant Ii: Health Departaent Approval <br />Flot3r re/J(/f. /1 <br />, <br /> <br />BUILDIIIG SIZE: <br /> <br />x <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDENTIAL: <br />COMMERCIAL : <br /> <br />ATTACH (2) PLOT PLAIIS Ii: (2) SETS OF BUILDING PLAHS Ii: (1) SET ENERGY FORMS. <br />ATTACH (3) SETS OF BUILDIIIG PLAHS Ii: (1) SET EIIERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW COIISTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />-----BUILDIIIG <br /> <br />$ <br /> <br />Valuation of Total Construction <br /> <br />_ELECTlUCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-1IECllAllICAL <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUHBIIIG GAS ROOFIIIG <br /> <br />SPECIALTY . <br /> <br />TYPE OF OOIlSTRUcnOIl: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FDlISHED FlOOR ELEVAnOIlS: <br /> <br />Fr. <br /> <br />IS PROJEct III FlOOD ZOIlE AREA T <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />RIJTl.DRR <br /> <br />Signature pS <br /> <br />CONTRACTOR SECTION <br /> <br />COHPAIIY G~..,<.. fMYI~ BtA,'JjJ</s <br />____ c::::;:::::::> "State Cert. or Regist. . aco 1,/ > 9' /' g <br />~ City License Registration . <br />.......................................... <br /> <br />SiooAture <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />F.l.RCTlUCIAII <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />PLUMBER <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />HECHARICAL <br /> <br />Signature <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />OTRRR <br /> <br />Signature <br /> <br />APPLICATIOII APPROVED BY <br /> <br />PERMIT OFFICER. <br />