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<br />APPLICATION FOR PERKIT <br />CITY OF ZEPIIYIUIllJ.S <br />BUILDING DEPARIItENT <br /> <br />/ <br /> <br />I,,:""";" <br />/ ,) , <br /> <br />LEGAL DESCJUPTI.ON: <br /> <br /> <br />BLOCK <br /> <br />SUBDIVISION <br /> <br />OWNER · S NAItE <br /> <br />OWNER'S ADDKESS <br /> <br />JOB ADDRESS <br /> <br />PARCEL 1.D.' <br /> <br />WORK PROPOSED:_Nev Construction ---Addition _Alteration ~pair _Install <br /> <br />--1iign <br /> <br />_Hove <br /> <br />_D~lish <br /> <br />PROPOSED USE: <br /> <br />Single Fallily <br /> <br />_"'F <br /> <br />_' of Units <br /> <br />---1'l/H <br /> <br />_ec-ercial <br /> <br />_Indust. <br /> <br />_Swia. Pool <br /> <br />Other <br /> <br />----Restaurant. Health Departaent Approval <br /> <br />BUILDING SIZE: <br /> <br />x <br /> <br />Square Feet. <br /> <br />Height <br /> <br />RESIDENTIAL: <br />cottKERCIAL : <br /> <br />AtTACH (2) PI.OT PLAIiS . (2) SETS OF BUILDllIG PLANS . (1) SET ENERGY FORMS. <br />AtTACH (3) SETS OF BUILDING PLANS . (1) SET ENERGY FORMS. <br />PROPERTY SURVEY RlIQU1RED FOR ALL lil1.V CONSTRUcnON. <br /> <br />_BUILDING <br /> <br />I . PERlUTS l\IlIIIDlSYED <br /> <br />$. )U1;u ~ Valuati~ of Total <br />I <br />i <br />, <br /> <br />Construction <br /> <br />_ELECfRICAL <br /> <br />AIIP Secv ice <br /> <br />Florida Power Corp. <br /> <br />W.R.E.C. <br /> <br />_flEGIIAlO.CAL <br /> <br />$. <br /> <br />Valuation of Mechanical Installation <br /> <br />_PLUHBIBG <br /> <br />GAS <br /> <br />ROOFIl'iG <br /> <br />SPECIALTY <br /> <br />TYPE OF CORSmUCI'I.OB: _Block _Fraae _Steel <br /> <br />Other <br /> <br />FINISHED FLOOR ELEVATIONS: <br /> <br />FT. <br /> <br />IS PROJECT IN FLOOD ZONE AREA? <br /> <br />YES NO <br /> <br />******-*********************************** <br /> <br /> <br /> <br />BUILDER COKPAIfY <br />State Cer . <br />Signature City License Registration . <br />****************************************** <br /> <br /> <br />RI.F.CTRl.CI.AB COKPABY <br />State Cert. or Regist. . <br />SiPD~ture City License Registration . <br />****************************************** <br /> <br />PLUHBER GOtIPANY <br />State Cert.. or Regist. . <br />Signature City License Registration t <br />**************.*************************** <br /> <br />ItEGIIAlO.CAL COKPABY <br />State Cert. or Regist. t <br />Signature City License Registration t <br />********************.********************* <br /> <br />OTRRR , GOtIPANY <br />State Cert. or Regist. t <br />Signature City License Registration t <br />**************.*************************** <br /> <br />APPLICATION APP.ROVED BY PERKIT OFFICER. <br />