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<br />~ U)(; . <br />Z~ DO <br /> <br />,.. <br /> <br />APPLICATION FOR PERKlT <br />CITY OF ZEPIIYRIIILLS <br />BUILDIHG DEPAR'l'ItEBT <br /> <br />tN I<<Z-O p~ <br />~~ S'7f~ <br /> <br />(Of <br />110/ A./ e./rL, <br />e '("~if '? <br /> <br />PHONE <br /> <br />'(61 ~~3i> <br /> <br />BLOCIL--.SUBDIVISION <br /> <br />(OBTAIN FROM. PROPERTY TAX NOTICE) <br /> <br />J. ----^ddition ---Alteration ---.-.Jtepair _Install <br /> <br />_Sign <br /> <br />~ve <br /> <br />~lish <br /> <br />PROPOSED USE: ~ing1e F_ily <br /> <br />---.Jt/F _' of Units ---.Jt/H <br /> <br />_ec-ercial <br /> <br />_Indust. _Swill. Pool _Other <br /> <br />---.-.Jtestaurant &: Health Departaent Approval <br />DESCRIPTIOR OP WORK: ~ i3 VI L.-V <br /> <br />9 ~,J(':z3 <br /> <br />, <br /> <br />Sc,euy i?e0t1 <br /> <br />BUILDIHG SIZE: <br /> <br />x <br /> <br />, :L ~ D Square Feet, <br />- <br /> <br />Height <br /> <br />RESIDEIITIAL: <br />COHHERCIAL : <br /> <br />AtTACH (2) PLOT PLARS &: (2) SETS OP BUlLDIHG PLANS &: (1) SET ERERGY FORKS. <br />AtTACH (3) SETS OP BUlLDIHG PLANS &: (1) SET ERERGY FORKS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CORSTRUCTIOR. <br /> <br />PERKITS REOUESTED <br /> <br />~UILDIHG <br /> <br />$ <br /> <br />. ri) <br />/17~ Ii <br /> <br />Valuation of Total Construction . <br /> <br />RT.RcnuCAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />----1IECIIAlIICAL <br /> <br />$ <br /> <br />Valuation of llechanical Installation <br /> <br />-PLUHBIHG <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPE OP CORSTRucnOR: ______lock _Praae _Steel <br /> <br />Other <br /> <br />PDlISBED FLOOR ELBVAfiORS: <br /> <br />Fl. <br /> <br />IS PROJECT IN FLOOD ZORE AREA., <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BUILDER <br /> <br />" .' <br /> <br /> <br /><:-/f/ ~~~~ "=:~~=. <br /> <br />. ......................................... <br /> <br />CONTRACTOR SECTION <br />"'," <br /> <br />~if/-du~ <br />7,7 <br /> <br />Signature <br /> <br />RT,RCTRICIAII COMPANY <br />State Cert. or Regist. f <br />SianAture City License Registration . <br />.......................................... <br /> <br />PLlJIIBER COItPANY <br />State Cert. or Regist. f <br />Signature City License Registration . <br />.......................................... <br /> <br />IlECllANICAL COMPANY <br />State Cert. or Regist. . <br />Signature City License Registration f <br />.......................................... <br /> <br />OTRRR COMPANY <br />State Cert. or Regist. f <br />Signature City License Registration . <br />.......................................... <br /> <br />APPLICA1'IlIII APP1lllVBIl BY '11 ~ 1 !!1 tJ-b-~ PEIlIIIT OFFICER, <br />