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<br />APPLICATION FOR PIWIIT <br />CITY OF ZEPIIYRBILLS <br />BUlLDDlG DEPARTMENT <br /> <br />OWNER'S ~rctV) (' j s F JeLJV'V PHONE ~'f8tf -{P??Li I <br />_'S ADDUsS ~Lo5 / 7Z;/-r Pr;ii/(-" <br />JOB ADDRESS ,I _ _ _ ~?ctV- k:. io r _@ r <br /> <br />LEGAL DESCIUP'lION: LOT(S) <br /> <br />BLOCIL-SUBDIVISION <br /> <br />PARCEL I. D. # (OBTAIN FROM PROPERTY TAX NOTICE) <br />IlOIlK PIlOPOSJlD:~ CoIIstr:uction ---"'Idition ---..Alteration _pair -Iostall <br /> <br />_Sign <br /> <br />PROPOSED USE: ~e Faaily <br /> <br />-JIove ---Peaolish <br /> <br />---.Jt/F _' of Units -----If./H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swia. Pool _Other <br /> <br />__~ealth Depar~ <br /> <br />DESCRIPTION OF WORK: -b. cG- C ~ <br />301 I 3;< I 76/ 1/ <br />BUlLDDlG SIZB: X I /, ' IJO Square Feet, Height <br />. <br /> <br />RESIDENTIAL: <br />cottKERCIAL <br /> <br />ATTACH (2) PLOT PLABS &: (2) SBTS OF BUlLDDlG PLANS &: (1) SET ENERGY FORMS, <br />ATTACH (3) SETS OF BUILD DIG PLANS &: (1) SBT ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />~IHG <br /> <br />$ <br /> <br />. tf)O PERMITS REQUESTED <br />rY (LJOO ----Valuation of Total Construction <br /> <br />RI.RcrlUCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />N.R.E.C. <br /> <br />--lIBCllANICAL <br /> <br />$ <br /> <br />Valuation of Hechanical Installation <br /> <br />-PLUHBDG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPB OF CONSTRUcnON: -.JIlock -"raae _Steel <br /> <br />Other <br /> <br />FIllISBBD FJ.OOB. ELBVAnONS: <br /> <br />Fr. <br /> <br />IS PROJECl IN FLOOD ZONB AREA., <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br />'".)0 ...~. ~AH ... I Q JV),U <br />~ Pf- >!............JEr.~E::~:~::. - CD <br /> <br /> <br />RT_RCTRICL\II COMPANY { <br />State Cert. or Regist. . <br />SionAture City License Registration' <br />.......................................... <br /> <br /> <br />BIlTl.DRR <br /> <br /> <br />Sianature <br /> <br />PLUMBER COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration f <br />.......................................... <br /> <br />HECRANICAL COMPANY <br />State Cert. or Regist. # <br />Signature City License Registration f <br />.......................................... <br /> <br />OTRRR COHPANY <br />State Cert. or Regist. # <br />Sianature City License Registration f <br />.......................................... <br /> <br />APPLlCAnON APPROVED BY PIWIIT OFFICER, <br />