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<br />APPLICAnON FOR PERKIT <br />CITY OF ZEPIIYRBILLS <br />BUILDING DEPARnIENT <br /> <br />OWNER'S RAIlE r,ye 51 /~ s ~ u.5 tJ rt lei PHONE ( ?'/i) I ~c) - J cf\f' ~ <br />OWNER'S ADDRESS / 7' / P b L" I P It ~ / () IS> /& / (Y ~ I~ (} C! c1 t2 ~ /~ ~ ~ ..i' ~ 5> 9- () <br />I , <br /> <br />JOB ADDRESS to 'l Lj.j- n ~ / I .8 I u /. z p J> ,t{ '/ /c ;; .' / /...(' ~/ s ..j S-...y /" <br />, /" <br /> <br />LEGAL DESCRI.P'1'ION: LOT(S) <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />PARCEL I.D.' c:9 -.5- ;) ~ -,) / () & J 6'- ('JdCJO C7 -c!J /' 70 (OBTAIN FROM PROPERTY TAX NOTICE) <br />WORK PROPOSED:-Hew Construction --.ftddition ~eration -Jlepair _Install <br /> <br />----8ian <br /> <br />-.-JIove <br /> <br />->>eaolish <br /> <br />PROPOSED USE: _Single F8IIily <br />~erCial <br /> <br />----lI/F _' of Units ----lI/H <br /> <br />_Indust. _Swiat Pool _Other <br /> <br />Restaurant It Health Departllent Approval <br />DESCRIPTIOR OF WORK: -1 N -I C' It' ,. t' /2 K e j. ~ [) rI t? / 'j'-f (2 <br />/ <br /> <br />BUILDING SIZE: .s~ & X ^I .L, <br /> <br />Square Feet, <br /> <br />Height <br /> <br />RESIDEI1TL\L: AtTACH (2) PLOT PLANS It (2) SETS OF BUILDING PLANS It (1) SET ENERGY FORMS. <br />COMMERCIAL: AtTACH (3) SETS OF BUILDING PLANS It (1) SET ENERGY FORMS. <br />. PROPERTY SURVEY REQUIRED FOR ALL NEW CONSTRUCTION. <br /> <br />PERMITS REOUESTED <br /> <br />~UlLDING <br /> <br />$ /f,&c90 <br /> <br />Valuation of Total Construction <br /> <br />RT.Rct'RI.CAL <br /> <br />AIIP Service <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />-JlEClWlICAL <br />-PLUHBIBG <br /> <br />$ <br /> <br />Valuation of Mechanical Installation <br /> <br />GAS <br /> <br />ROOFING <br /> <br />SPECIALTY . <br /> <br />TYPE OF CORSTRUCTION: -Block _Fraae _Steel <br /> <br />Other <br /> <br />FDfISBED FLOOB. ELEVAnOIfS: <br /> <br />Fr. <br /> <br />IS PROJECl IN FLOOD ZONE AREA' <br /> <br />.......................................... <br /> <br />YES NO <br /> <br />CONTRACTOR SECTION <br /> <br />.' <br /> <br />BUTT.DER /l " . . . ...'~"., '. aittPAIIY ~ ;{ "( . 1. . ~ )-<--1 .-/ k () tI /'- ,..r ;r!.' <br />/ / ~---/ /;;:/ ~ --47 State Cert. or Regist. . i: JS.3 ?"j.L./ <br />Signature~ A ~ City License Registration' 6 <br />~ .......................................... <br /> <br />COMPANY rl ( f!- ~r (1/ ~;) t:,; (e r'#p " e- <br />State Cert. or Regist. . //.5:/7 <br />City License Registration' /~~ <br />......................................... <br /> <br />PLUMI$ER <br /> <br /> <br />Signature <br /> <br />QlIIPAIIY (1)/;2/<; 6A'J~ ffiflliJ:t/6 <br />State Cert. or Regist.' ' )Q . >?' <br />City License Registration' ,l) 7 <br />.......................................... <br /> <br />IlECBANIGAL <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />OTRRR <br /> <br />COMPANY <br />State Cert. or Regist. . <br />City License Registration . <br />.......................................... <br /> <br />Signature <br /> <br />APPLICAnON APPROVED BY <br /> <br />PERKIT OFFI-cIR. <br />