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<br />APPLICAnON FOR PERMIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPARTMENT <br /> <br />c: .j <br />,/()j,'?' U~ .a-,~' '~,' .-2~) <br />/ J'- I-I,J <br />/ <br /> <br />OWNER'S IWtB /YJ, 4l- m rS <br /> <br />OWNER'S ADDRESS '50 '3 ~ <br /> <br />JOB ADDRESS 5' 0 '3 $I <br /> <br />HC10K~ <br />/ 7 rJ... 5 T... <br />I}T)... sT. <br /> <br />PHONE <br /> <br />7&:;)- ~S'3~_ <br /> <br />LEGAL DESCRIPlION: LOT(S) / I B~SUBDIVISION 6J.../ <br />PARCEL I. D.' (901 a - ;) J Lf 0 0 - ~ ':2 '-I CJ (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:-'lew Construction ----^<<Idition ~teration _Repair _Install <br /> <br />_Sign <br /> <br />--.JIove <br /> <br />->>eaGlish <br /> <br />PROPOSED USE: ~Sing1e F_ily <br />_ec:-ercial <br /> <br />---1t/F _' of Units _H/H <br /> <br />_1Ddust. _Swia. Pool _Other <br /> <br />~estaurant & Health Departaent Approval <br />DESCRIPTION OF WORK: G:YY\ vG-ft .$c.re~w..J t<c~ L'o A ol?i. -r;'~ <br /> <br />BUILDING SIZE: X Square Feet, Height <br /> <br />C--RESID~ ATTACH (2) PLOT PLANS & (2) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />CUftftKK : ATTACH (3) SETS OF BUILDING PLANS & (1) SET ENERGY FORMS. <br />PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REQUESTED <br /> <br />,./' BUILDING <br /> <br />t/ ELECl'RICAL <br /> <br />---1tECBANICAL <br />V PL~~G <br /> <br />$ 1'1, a.So.~ <br /> <br />Valuation of Total Construction <br /> <br />AHP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />$ <br /> <br />------.... <br /> <br />Valuation of Hechanica1 Installation <br /> <br />GAS <br />block <br /> <br />v- ROOFING <br /> <br />SPECIALTY <br /> <br />TYPE OF CONSTRUGTION: <br /> <br />_Fraae _Steel <br /> <br />Other <br /> <br />FDlISBED FLOOR ELEVAnONS: <br /> <br />FT. <br /> <br />IS PROJEC'r IN FLOOD ZONE A1lBA? <br /> <br />YES NO <br /> <br />.......................................... <br /> <br />BMlJ1ER <br /> <br />w;;r:;t <br /> <br />CONTRACTOR SECTION' <br /> <br />Signature <br /> <br />mHPARY Rem,. B:,LT Ccn,.,T'. IruC-. <br />State Gert. or Regist. 'RR.OO~qCf~1 <br />City License Registration' 7ft <br />.......................................... <br /> <br />RI.RC'l'RTt!T.&IJ, COHP~c.lt.All-P cJe~'yJ.4~ '-- pL€ c7>e, ~ L C d)()T <br /> <br />, v. . l' /'.. State Cert. or Regist. . <br />SianAture/~~"~{ C~'.tt-.,e~ City License Registration' .21/(1 <br />.......................................... <br /> <br />PLOMBER d COMPANY <br />State Cert. <br />Signature /1 ~;t--~--1~' 15a~ City License Registration' <br />.......................................... <br /> <br /> <br />IlECHANIGAL <br /> <br />COMPANY <br />State Gert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Gert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLlCAnOll APPIIllVBD BY '-11, ~ ~ n-,J if <br /> <br />PERMIT OFFICER. <br />